Provider Demographics
NPI:1033515895
Name:ORNDOFF, RONDA (NP)
Entity Type:Individual
Prefix:
First Name:RONDA
Middle Name:
Last Name:ORNDOFF
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RONDA
Other - Middle Name:
Other - Last Name:WANTLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:12230 LIONESS WAY
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-5603
Mailing Address - Country:US
Mailing Address - Phone:720-644-9355
Mailing Address - Fax:
Practice Address - Street 1:3676 PARKER BLVD STE 110
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008
Practice Address - Country:US
Practice Address - Phone:719-595-7707
Practice Address - Fax:719-595-7629
Is Sole Proprietor?:No
Enumeration Date:2014-11-06
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0991503363LF0000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO99006375Medicaid
CO382553YK2DMedicare PIN