Provider Demographics
NPI:1225739832
Name:ORELLANA, JALISA
Entity Type:Individual
Prefix:
First Name:JALISA
Middle Name:
Last Name:ORELLANA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JALISA
Other - Middle Name:
Other - Last Name:ORELLANA HARDY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4080 WARNER AVE APT A5
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-1902
Mailing Address - Country:US
Mailing Address - Phone:571-344-0331
Mailing Address - Fax:
Practice Address - Street 1:4080 WARNER AVE APT A5
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-1902
Practice Address - Country:US
Practice Address - Phone:571-344-0331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula