MEDICARE: FAITH A ORNELAS NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364S00000X	Clinical Nurse Specialist	70000079A	IN
2	364SP0808X	Psychiatric/Mental Health Clinical Nurse Specialist	70000079A	IN
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	70000079A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	90000854	OTHER	IL	BCBSIL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023004140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FAITH A ORNELAS NP

Provider Business Mailing Address
First Line	:	11357 MORTON CT
Second Line	:
City	:	CROWN POINT
State	:	IN
Zip	:	46307-4200
Country	:	US
Telephone Number	:	219-712-0016
Fax Number	:

Provider Business Practice Location Address
First Line	:	11357 MORTON CT
Second Line	:
City	:	CROWN POINT
State	:	IN
Zip	:	46307-4200
Country	:	US
Telephone Number	:	219-712-0016
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	12/27/2024

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Directions to “ FAITH A ORNELAS NP” Practice Location

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