Provider Demographics
NPI:1013263631
Name:SUTTON, ORLANDO SR (LPN)
Entity Type:Individual
Prefix:MR
First Name:ORLANDO
Middle Name:
Last Name:SUTTON
Suffix:SR
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-5005
Mailing Address - Country:US
Mailing Address - Phone:501-655-2134
Mailing Address - Fax:877-963-4263
Practice Address - Street 1:1000 WOODLAWN AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-5005
Practice Address - Country:US
Practice Address - Phone:501-655-2134
Practice Address - Fax:877-963-4263
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARL38404164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR8512OtherBUSINESS ID #