Healthcare Provider Details

I. General information

NPI: 1225669138
Provider Name (Legal Business Name): INGRID J ORTIZ FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2020
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11803 JEFFERSON AVE STE 230
NEWPORT NEWS VA
23606-4390
US

IV. Provider business mailing address

11803 JEFFERSON AVE STE 230
NEWPORT NEWS VA
23606-4390
US

V. Phone/Fax

Practice location:
  • Phone: 757-457-5100
  • Fax: 757-534-7701
Mailing address:
  • Phone: 757-457-5100
  • Fax: 757-534-7701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024178554
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: