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General NPI Number Information
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NPI Number | 1184221160
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Entity Type | Individual
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Provider Name | ZACHARY WADE ORR AGNP-C
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Gender | Male
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Dates
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Enumeration Date | 10/02/2020
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 300 FORBY RD
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City | EUREKA
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State | MO
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Zip | 63025-2321
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Country | US
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Telephone | 636-938-5151
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Fax | 636-938-5266
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Provider Business Mailing Address
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Address Line | PO BOX 270653
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City | SAINT LOUIS
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State | MO
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Zip | 63127-0653
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Country | US
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Telephone | 217-257-8677
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Fax | 636-333-4510
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 2020030165
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License Number State | MO
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