Provider Demographics
NPI:1801873260
Name:ORR, MAUREEN ANN (MSN,FNP)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ANN
Last Name:ORR
Suffix:
Gender:F
Credentials:MSN,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 BLANCA AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMOSA
Mailing Address - State:CO
Mailing Address - Zip Code:81101-2340
Mailing Address - Country:US
Mailing Address - Phone:719-589-3000
Mailing Address - Fax:719-587-1372
Practice Address - Street 1:106 BLANCA AVE
Practice Address - Street 2:
Practice Address - City:ALAMOSA
Practice Address - State:CO
Practice Address - Zip Code:81101-2340
Practice Address - Country:US
Practice Address - Phone:719-589-3000
Practice Address - Fax:719-587-1372
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO61369363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO89284224Medicaid
COP00364186OtherMEDICARE RAILROAD
CO840255530041OtherROCKY MTN HEALTH PLANS
COP67784Medicare UPIN
COC804840Medicare PIN