MEDICARE: KAREN ELIZABETH ORR

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	F331029-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F331029-1	OTHER	NY	NYS NURSE PRACT LICENSE

General Provider Information

NPI Number	:	1669520920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN ELIZABETH ORR

Provider Business Mailing Address
First Line	:	103 BARNSTABLE CT
Second Line	:
City	:	CAMILLUS
State	:	NY
Zip	:	13031-2059
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5075 W SENECA TPKE
Second Line	:	VAN DUYN HOME & HOSPITAL
City	:	SYRACUSE
State	:	NY
Zip	:	13215-2292
Country	:	US
Telephone Number	:	315-435-5511
Fax Number	:	315-435-5520

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

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	07/08/2007

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