MEDICARE: DENICE AYALA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide	A00200819	MD

General Provider Information

NPI Number	:	1568197317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENICE AYALA

Provider Business Mailing Address
First Line	:	3221 WALTERS LN APT 204
Second Line	:
City	:	DISTRICT HEIGHTS
State	:	MD
Zip	:	20747-3115
Country	:	US
Telephone Number	:	240-970-0655
Fax Number	:

Provider Business Practice Location Address
First Line	:	3221 WALTERS LN APT 204
Second Line	:
City	:	DISTRICT HEIGHTS
State	:	MD
Zip	:	20747-3115
Country	:	US
Telephone Number	:	240-970-0655
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2022
Last Update Date	:	07/17/2022

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Directions to “ DENICE AYALA ” Practice Location

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