Provider Demographics
NPI:1962177055
Name:ORR, ALYSSA KATE (PHARMD)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:KATE
Last Name:ORR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTE
Mailing Address - State:IA
Mailing Address - Zip Code:52142-9301
Mailing Address - Country:US
Mailing Address - Phone:563-425-4530
Mailing Address - Fax:563-425-3502
Practice Address - Street 1:238 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FAYETTE
Practice Address - State:IA
Practice Address - Zip Code:52142-9301
Practice Address - Country:US
Practice Address - Phone:563-425-4530
Practice Address - Fax:563-425-3502
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA24172183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist