Provider Demographics
NPI:1174973846
Name:ORSLENE, KATELYN (OD)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:ORSLENE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 HUMPHREY RD
Mailing Address - Street 2:PINE VIEW PLACE SUITE 1
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-4579
Mailing Address - Country:US
Mailing Address - Phone:723-834-8033
Mailing Address - Fax:
Practice Address - Street 1:5256 ROUTE 30 STE 235
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-7829
Practice Address - Country:US
Practice Address - Phone:724-834-9229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAOEG003161152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program