MEDICARE: ANGELA ORSBORN CFNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	R758732	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063430296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA ORSBORN CFNP

Provider Business Mailing Address
First Line	:	200 HWY 30 W
Second Line	:
City	:	NEW ALBANY
State	:	MS
Zip	:	38652-3112
Country	:	US
Telephone Number	:	662-538-2150
Fax Number	:	662-538-2571

Provider Business Practice Location Address
First Line	:	200 HWY 30 W
Second Line	:
City	:	NEW ALBANY
State	:	MS
Zip	:	38652-3112
Country	:	US
Telephone Number	:	662-538-2150
Fax Number	:	662-538-2571

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	09/16/2011

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