Provider Demographics
NPI:1881973162
Name:ONDOBO, GEORGETTE MIRABELLE (MSN)
Entity type:Individual
Prefix:MRS
First Name:GEORGETTE
Middle Name:MIRABELLE
Last Name:ONDOBO
Suffix:
Gender:
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 E ARISTOTLE AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-9881
Mailing Address - Country:US
Mailing Address - Phone:302-534-2301
Mailing Address - Fax:
Practice Address - Street 1:1940 E ARISTOTLE AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-9881
Practice Address - Country:US
Practice Address - Phone:302-534-2301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X
DELG-0001347363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily