Provider Demographics
NPI:1194101998
Name:ORRIS, VANESSA I (MSN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:I
Last Name:ORRIS
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2126 KLINES MILL RD
Mailing Address - Street 2:
Mailing Address - City:BOSWELL
Mailing Address - State:PA
Mailing Address - Zip Code:15531-2544
Mailing Address - Country:US
Mailing Address - Phone:814-242-3532
Mailing Address - Fax:
Practice Address - Street 1:745 RAYSTOWN ROAD
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:PA
Practice Address - Zip Code:15537
Practice Address - Country:US
Practice Address - Phone:814-348-4080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-04
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP027597363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily