Provider Demographics
NPI:1700531977
Name:AYALA, JEZEBEL
Entity Type:Individual
Prefix:
First Name:JEZEBEL
Middle Name:
Last Name:AYALA
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 1:905 WHISPERING CIR APT 8
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-0898
Mailing Address - Country:US
Mailing Address - Phone:646-363-9340
Mailing Address - Fax:
Practice Address - Street 1:905 WHISPERING CIR APT 8
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-0898
Practice Address - Country:US
Practice Address - Phone:646-363-9340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula