Provider Demographics
NPI:1245516988
Name:ORNELAS, ANA PAULA (NUTRITIONIST,MS)
Entity type:Individual
Prefix:MRS
First Name:ANA PAULA
Middle Name:
Last Name:ORNELAS
Suffix:
Gender:F
Credentials:NUTRITIONIST,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MAIN ST STE 12
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-5558
Mailing Address - Country:US
Mailing Address - Phone:978-538-1313
Mailing Address - Fax:
Practice Address - Street 1:9 MAIN ST STE 12
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-5558
Practice Address - Country:US
Practice Address - Phone:978-538-1313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist