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General NPI Number Information
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NPI Number | 1174559520
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Entity Type | Individual
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Provider Name | JACQUELINE S ORENDER DO
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Gender | Female
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 2305 S. TUCKER TERRACE
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City | PITTSBURG
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State | KS
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Zip | 66762
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Country | US
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Telephone | 620-231-3132
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Fax | 620-231-3133
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Provider Business Mailing Address
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Address Line | 2305 S. TUCKER TERRACE
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City | PITTSBURG
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State | KS
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Zip | 66762-2026
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Country | US
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Telephone | 620-231-3132
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Fax | 620-231-3133
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0529686
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License Number State | KS
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