Provider Demographics
NPI:1538202445
Name:ORDAZ, RITA AGNES (APRN)
Entity type:Individual
Prefix:MRS
First Name:RITA
Middle Name:AGNES
Last Name:ORDAZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7102 WOOD BRIAR RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-6200
Mailing Address - Country:US
Mailing Address - Phone:502-329-4911
Mailing Address - Fax:
Practice Address - Street 1:4501 LOUISE UNDERWOOD WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-3987
Practice Address - Country:US
Practice Address - Phone:502-368-2348
Practice Address - Fax:502-368-2340
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY2432P363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health