Healthcare Provider Details

I. General information

NPI: 1700723525
Provider Name (Legal Business Name): YORDI ORELLANA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 TURNER MCCALL BLVD SW
ROME GA
30165-5621
US

IV. Provider business mailing address

17 CROSSCREEK DR NW
ROME GA
30165-1202
US

V. Phone/Fax

Practice location:
  • Phone: 706-509-6110
  • Fax:
Mailing address:
  • Phone: 706-767-3490
  • Fax: 706-767-3490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN302835
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: