Provider Demographics
NPI:1164025805
Name:AYALA, DALILA (RN)
Entity Type:Individual
Prefix:
First Name:DALILA
Middle Name:
Last Name:AYALA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 W KORTSEN RD
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-5910
Mailing Address - Country:US
Mailing Address - Phone:520-876-3243
Mailing Address - Fax:
Practice Address - Street 1:220 W KORTSEN RD
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-5910
Practice Address - Country:US
Practice Address - Phone:520-876-3243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ230588163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool