Healthcare Provider Details

I. General information

NPI: 1023004140
Provider Name (Legal Business Name): FAITH A ORNELAS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11357 MORTON CT
CROWN POINT IN
46307-4200
US

IV. Provider business mailing address

11357 MORTON CT
CROWN POINT IN
46307-4200
US

V. Phone/Fax

Practice location:
  • Phone: 219-712-0016
  • Fax:
Mailing address:
  • Phone: 219-712-0016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number70000079A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number70000079A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number70000079A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: