Provider Demographics
NPI:1720669567
Name:ORLIC, JENNIFER GLEVA (CRNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:GLEVA
Last Name:ORLIC
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3295 PA ROUTE 100
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062
Mailing Address - Country:US
Mailing Address - Phone:610-967-5684
Mailing Address - Fax:
Practice Address - Street 1:3295 PA ROUTE 100
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18602
Practice Address - Country:US
Practice Address - Phone:610-967-5684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023105363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily