Provider Demographics
NPI:1962485367
Name:ONDO, LOUELLA J (CRNP)
Entity Type:Individual
Prefix:MS
First Name:LOUELLA
Middle Name:J
Last Name:ONDO
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 1:619 TANOMA RD
Mailing Address - Street 2:
Mailing Address - City:HOME
Mailing Address - State:PA
Mailing Address - Zip Code:15747-9019
Mailing Address - Country:US
Mailing Address - Phone:724-349-7519
Mailing Address - Fax:
Practice Address - Street 1:619 TANOMA RD
Practice Address - Street 2:
Practice Address - City:HOME
Practice Address - State:PA
Practice Address - Zip Code:15747-9019
Practice Address - Country:US
Practice Address - Phone:724-349-7519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP005626W363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily