Provider Demographics
NPI:1821691387
Name:ORREN, NISHA (PA-C)
Entity type:Individual
Prefix:
First Name:NISHA
Middle Name:
Last Name:ORREN
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7610 CARROLL AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6321
Mailing Address - Country:US
Mailing Address - Phone:301-891-6141
Mailing Address - Fax:
Practice Address - Street 1:7610 CARROLL AVE STE 400
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6321
Practice Address - Country:US
Practice Address - Phone:301-891-6141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0007889208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics