Provider Demographics
NPI:1477017887
Name:OMONDI, VICTORIA O (RN,MSN)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:O
Last Name:OMONDI
Suffix:
Gender:F
Credentials:RN,MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6806 LAKE JACKSON DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-4050
Mailing Address - Country:US
Mailing Address - Phone:817-793-1048
Mailing Address - Fax:
Practice Address - Street 1:6806 LAKE JACKSON DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76002-4050
Practice Address - Country:US
Practice Address - Phone:817-793-1048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX757453163WP0200X, 163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No163WP0200XNursing Service ProvidersRegistered NursePediatrics