Provider Demographics
NPI:1639978596
Name:LOUIS, TAIBELLA ANNA (RN)
Entity type:Individual
Prefix:
First Name:TAIBELLA
Middle Name:ANNA
Last Name:LOUIS
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 SAINT MARKS AVE APT 4H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-3679
Mailing Address - Country:US
Mailing Address - Phone:917-981-1757
Mailing Address - Fax:
Practice Address - Street 1:641 SAINT MARKS AVE APT 4H
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-3679
Practice Address - Country:US
Practice Address - Phone:917-981-1757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY936644163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse