Healthcare Provider Details

I. General information

NPI: 1881363653
Provider Name (Legal Business Name): KRISTEN ALICIA ORELUP PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2021
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E GALLATIN ST UNIT 102
MANHATTAN MT
59741-2219
US

IV. Provider business mailing address

115 E GALLATIN ST UNIT 102
MANHATTAN MT
59741-2219
US

V. Phone/Fax

Practice location:
  • Phone: 406-284-2021
  • Fax: 406-389-4616
Mailing address:
  • Phone: 406-284-2021
  • Fax: 406-389-4616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMED-PAC-LIC-102277
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: