Provider Demographics
NPI:1609955525
Name:ORTIZ, JANA JENELLE (FNP)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:JENELLE
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 S MOPAC EXPY
Mailing Address - Street 2:SUITE 450
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-7009
Mailing Address - Country:US
Mailing Address - Phone:512-329-9223
Mailing Address - Fax:512-329-5632
Practice Address - Street 1:1601 S MOPAC EXPY
Practice Address - Street 2:SUITE 450
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-7009
Practice Address - Country:US
Practice Address - Phone:512-329-9223
Practice Address - Fax:512-329-5632
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA494884163WP2201X
OKR0084712363LF0000X
TX748540363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care