Provider Demographics
NPI:1720676828
Name:URIBE, ORLANDO GUILLERMO JR (CRNP)
Entity Type:Individual
Prefix:
First Name:ORLANDO
Middle Name:GUILLERMO
Last Name:URIBE
Suffix:JR
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 VOLUNTEER DR
Mailing Address - Street 2:
Mailing Address - City:TUSCUMBIA
Mailing Address - State:AL
Mailing Address - Zip Code:35674-3123
Mailing Address - Country:US
Mailing Address - Phone:256-627-7507
Mailing Address - Fax:
Practice Address - Street 1:216 MARENGO ST STE A
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-6034
Practice Address - Country:US
Practice Address - Phone:256-760-8289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-070903363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily