MISS JAMIE LYNN ORZECH, PA-C - NPI NUMBER 1164694162

Summary

Provider Name: MISS JAMIE LYNN ORZECH, PA-C

NPI Number: 1164694162

Clasification: Physician Assistant (363AS0400X)

Specialization: Surgical

Address:
192 TILLEY DR
SOUTH BURLINGTON, VT
ZIP 05403

Phone Number: (802) 847-6000



Detailed Information

MISS Jamie Lynn Orzech, PA-C is a surgical physician assistant in South Burlington, VT. The assigned NPI number for this provider is 1164694162 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business address is:

192 TILLEY DR
SOUTH BURLINGTON, VT
ZIP 05403-440
Phone: (802) 847-6000

The enumeration date for this NPI number is 3/31/2008 and was last updated on 3/22/2012.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 363AS0400X Physician Assistant Surgical 055-0030905 VT Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 900374 MEDICAID VT
2 0005183 MEDICARE PIN

NPI Record

No. Field Name Field Value
1 NPI 1164694162
2 Entity Type Code 1
3 Provider Last Name Legal Name ORZECH
4 Provider First Name JAMIE
5 Provider Middle Name LYNN
6 Provider Name Prefix Text MISS
7 Provider Credential Text PA-C
8 Provider Other Last Name LAFOUNTAIN
9 Provider Other First Name JAMIE
10 Provider Other Middle Name ORZECH
11 Provider Other Name Prefix Text MRS.
12 Provider Other Credential Text PA-C
13 Provider Other Last Name Type Code 1
14 Provider First Line Business Practice Location Address 192 TILLEY DR
15 Provider Business Practice Location Address City Name SOUTH BURLINGTON
16 Provider Business Practice Location Address State Name VT
17 Provider Business Practice Location Address Postal Code 054034440
18 Provider Business Practice Location Address Country Code If outside U S US
19 Provider Business Practice Location Address Telephone Number 8028476000
20 Provider Enumeration Date 3/31/2008
21 Last Update Date 3/22/2012
22 Provider Gender Code F
23 Healthcare Provider Taxonomy Code 1 363AS0400X
24 Provider License Number 1 055-0030905
25 Provider License Number State Code 1 VT
26 Healthcare Provider Primary Taxonomy Switch 1 Y
27 Other Provider Identifier 1 900374
28 Other Provider Identifier Type Code 1 05
29 Other Provider Identifier State 1 VT
30 Other Provider Identifier 2 0005183
31 Other Provider Identifier Type Code 2 08
32 Is Sole Proprietor N

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This page was last updated on: 7/15/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.