Provider Demographics
NPI:1568428373
Name:ORTIZ, TINA LOUISE (CPNP)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:LOUISE
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:LOUISE
Other - Last Name:NAWROCKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6464 SUTCLIFFE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315
Mailing Address - Country:US
Mailing Address - Phone:703-971-4989
Mailing Address - Fax:202-762-1705
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:NATIONAL NAVAL MEDICAL CENTER
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889
Practice Address - Country:US
Practice Address - Phone:301-295-5200
Practice Address - Fax:301-295-5928
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN150332NP163WP0200X
DCRN1004813ARNP163WP0200X
FLARNP2168922363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WP0200XNursing Service ProvidersRegistered NursePediatrics
Not Answered363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics