Provider Demographics
NPI:1558426726
Name:ONDRASIK, LORRAINE A (CRNP)
Entity Type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:A
Last Name:ONDRASIK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 COLUMBIA PIKE STE 200
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-4209
Mailing Address - Country:US
Mailing Address - Phone:703-717-7545
Mailing Address - Fax:703-271-8585
Practice Address - Street 1:3401 COLUMBIA PIKE STE 200
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-4209
Practice Address - Country:US
Practice Address - Phone:703-717-7545
Practice Address - Fax:703-271-8585
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024056017363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P38657Medicare UPIN
007977M92Medicare ID - Type Unspecified