Basic Information
Provider Information
NPI: 1033240494
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OROURKE BABB
FirstName: PAUL
MiddleName: CLIFFORD
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2145 5TH AVENUE
Address2:  
City: OROVILLE
State: CA
PostalCode: 95965
CountryCode: US
TelephoneNumber: 5305345394
FaxNumber: 5305343820
Practice Location
Address1: 2145 5TH AVENUE
Address2:  
City: OROVILLE
State: CA
PostalCode: 95965
CountryCode: US
TelephoneNumber: 5305345394
FaxNumber: 5305343820
Other Information
ProviderEnumerationDate: 03/08/2007
LastUpdateDate: 11/12/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN329582CAN Nursing Service ProvidersRegistered Nurse 
363L00000XFNP4362CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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