Provider Demographics
NPI:1982146320
Name:ORR, NATHAN (NAVY SFIDC)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:ORR
Suffix:
Gender:M
Credentials:NAVY SFIDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USS PREBLE (DDG-88)
Mailing Address - Street 2:UNIT 100196
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96675
Mailing Address - Country:US
Mailing Address - Phone:808-471-2435
Mailing Address - Fax:
Practice Address - Street 1:USS PREBLE (DDG-88)
Practice Address - Street 2:UNIT 100196
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96675
Practice Address - Country:US
Practice Address - Phone:808-471-2435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman