Individual
JACOB ANTHONY ORRINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 W HOSPITAL RD, FORT EISENHOWER, GA 30905-5741
(706) 787-5142
Mailing address
300 W HOSPITAL RD, FORT EISENHOWER, GA 30905-5741
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
NUR-RN-LIC-47903
MT
363LF0000X
Family Nurse Practitioner
Primary
NUR-APRN-LIC-196787
MT
Other
Enumeration date
09/14/2020
Last updated
11/01/2023
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