Doctor Name: | JACKIE L OREN |
NPI Number: | 1619036316 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 0024165297 |
Business Practice Address: | 107 Dmv Drive Kilmarnock, VA - 22482 |
Business Phone Number: | 8044353103 |
Business Fax Number: | 8044356695 |
Mailing Address: | 107 Dmv Drive, Po Box 1599 KILMARNOCK |
State: | VA |
Postal Code: | 22482 |
Phone Number: | 8044353103 |
Fax Number: | 8044356695 |
NPI Enumeration Date: | 12/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 0024165297 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |