MEDICARE: MS. LOUELLA J. ONDO CRNP

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	363LF0000X	Family Nurse Practitioner	VP005626W	PA

General Provider Information

NPI Number	:	1962485367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LOUELLA J. ONDO CRNP

Provider Business Mailing Address
First Line	:	619 TANOMA RD
Second Line	:
City	:	HOME
State	:	PA
Zip	:	15747-9019
Country	:	US
Telephone Number	:	724-349-7519
Fax Number	:

Provider Business Practice Location Address
First Line	:	619 TANOMA RD
Second Line	:
City	:	HOME
State	:	PA
Zip	:	15747-9019
Country	:	US
Telephone Number	:	724-349-7519
Fax Number	:

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

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	07/08/2007

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