Provider Demographics
NPI:1659037224
Name:IRAOLA, TAISHA N
Entity Type:Individual
Prefix:MS
First Name:TAISHA
Middle Name:N
Last Name:IRAOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TAISHA
Other - Middle Name:N
Other - Last Name:IRAOLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSIRAOLA
Mailing Address - Street 1:YAUREL SECTOR SANTA CLARA
Mailing Address - Street 2:PARCELAS 221
Mailing Address - City:ARROYO
Mailing Address - State:PR
Mailing Address - Zip Code:00714-0504
Mailing Address - Country:US
Mailing Address - Phone:787-450-0006
Mailing Address - Fax:
Practice Address - Street 1:YAUREL SECTOR SANTA CLARA
Practice Address - Street 2:PARCELAS 221
Practice Address - City:ARROYO
Practice Address - State:PR
Practice Address - Zip Code:00714-0504
Practice Address - Country:US
Practice Address - Phone:787-450-0006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR70648163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse