Provider Demographics
NPI:1881739456
Name:JEAN PIERRE, OVANDO
Entity type:Individual
Prefix:
First Name:OVANDO
Middle Name:
Last Name:JEAN PIERRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 KEMPSVILLE RD FL 1
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3920
Mailing Address - Country:US
Mailing Address - Phone:757-261-8070
Mailing Address - Fax:
Practice Address - Street 1:901 E PRINCESS ANNE RD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504-2732
Practice Address - Country:US
Practice Address - Phone:757-626-1642
Practice Address - Fax:757-626-1971
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052240363A00000X
VA0110006963363A00000X
NY004921363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMJ1386766OtherDEA
NYMJ1386766OtherDEA