Provider Demographics
NPI:1063275857
Name:ORR, JENNIFER MAE
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MAE
Last Name:ORR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MAE
Other - Last Name:HEDSTRAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:516 19TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-6422
Mailing Address - Country:US
Mailing Address - Phone:701-500-2588
Mailing Address - Fax:
Practice Address - Street 1:516 19TH AVE SW
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-6422
Practice Address - Country:US
Practice Address - Phone:701-500-2588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide