Doctor Name: | FAITH A ORNELAS |
NPI Number: | 1023004140 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CNS |
License Number: | 70000079A |
Business Practice Address: | 24 Joliet St Dyer, IN - 463111705 |
Business Phone Number: | 2193225747 |
Business Fax Number: | 2198642282 |
Mailing Address: | Po Box 1000, DYER |
State: | IN |
Postal Code: | 463110800 |
Phone Number: | 2198642107 |
Fax Number: | 2198642649 |
NPI Enumeration Date: | 09/23/2005 |
NPI Last Update Date: | 07/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SP0807X |
License Number: | 70000079A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Psych/Mental Health, Child & Adolescent |
Taxonomy Definition: |