MRS. AYNESSA D. MONDLAK RN MSN C-FNP NPI 1407977192

NPI Information

NPI: 1407977192
Provider Name: MRS. AYNESSA D. MONDLAK, RN, MSN, C-FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: ST. MARY'S MEDICAL MANAGEMENT, LLC

PECOS Registration: Yes

Address:
2900 1ST AVE
HUNTINGTON, WV
ZIP 25702
Phone: (304) 526-1872
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MRS. Aynessa D. Mondlak, RN, MSN, C-FNP is a family nurse practitioner in Huntington, WV with 25 years of experience. MRS. Aynessa D. Mondlak, RN, MSN, C-FNP NPI is 1407977192. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2900 1ST AVE
HUNTINGTON, WV
ZIP 25702-241
Phone: (304) 526-1872
Fax: (304) 526-1809

The NPI 1407977192 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/2/2007 and was last updated on 8/28/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	49147	WEST VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1073953	OTHER	WEST VIRGINIA	WV COMPENSATION
2	Q51900	MEDICARE UPIN	WEST VIRGINIA
3	5100071	MEDICARE ID-TYPE UNSPECIFIED	WEST VIRGINIA
4	3810012715	MEDICAID	WEST VIRGINIA
5	MONP78112	MEDICARE PIN	WEST VIRGINIA
6	000000272703	OTHER	OHIO	OH UNISON
7	613154600	OTHER	WEST VIRGINIA	FEDERAL BLACK LUNG/FECA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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