Provider Demographics
NPI:1952695132
Name:ORSAK, JENNIFER LYNN (EMT BASIC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:ORSAK
Suffix:
Gender:F
Credentials:EMT BASIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44827 CARY LN
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:TX
Mailing Address - Zip Code:77445-8903
Mailing Address - Country:US
Mailing Address - Phone:832-278-7682
Mailing Address - Fax:
Practice Address - Street 1:44827 CARY LN
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:TX
Practice Address - Zip Code:77445-8903
Practice Address - Country:US
Practice Address - Phone:832-278-7682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-05
Last Update Date:2011-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)