Provider Demographics
NPI:1134700156
Name:AISOLA, PATRICE E
Entity Type:Individual
Prefix:
First Name:PATRICE
Middle Name:E
Last Name:AISOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 N MERRILL AVE APT 218
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-3684
Mailing Address - Country:US
Mailing Address - Phone:972-854-4710
Mailing Address - Fax:
Practice Address - Street 1:410 N MERRILL AVE APT 218
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-3684
Practice Address - Country:US
Practice Address - Phone:972-854-4710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX338961164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse