Provider Demographics
NPI:1124847611
Name:ONDARA, ADAMS (RN)
Entity type:Individual
Prefix:
First Name:ADAMS
Middle Name:
Last Name:ONDARA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7172 KITTREDGE CV
Mailing Address - Street 2:
Mailing Address - City:OTSEGO
Mailing Address - State:MN
Mailing Address - Zip Code:55301-4727
Mailing Address - Country:US
Mailing Address - Phone:612-229-7013
Mailing Address - Fax:
Practice Address - Street 1:7172 KITTREDGE CV
Practice Address - Street 2:
Practice Address - City:OTSEGO
Practice Address - State:MN
Practice Address - Zip Code:55301-4727
Practice Address - Country:US
Practice Address - Phone:612-229-7013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2484575163WC1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development