Provider Demographics
NPI:1881217883
Name:ORIAIFO, SIOBHAN
Entity Type:Individual
Prefix:
First Name:SIOBHAN
Middle Name:
Last Name:ORIAIFO
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 1:5588 CIRCLE STONE LANE
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30088-1226
Mailing Address - Country:US
Mailing Address - Phone:470-469-0860
Mailing Address - Fax:
Practice Address - Street 1:UNITYPOINT HEALTH -ALLEN HOSPITAL
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-3009
Practice Address - Country:US
Practice Address - Phone:470-469-0860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-26
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX853096163WP0808X
TX1056304363LP0808X
IAG168981363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health