Provider Demographics
NPI:1427486455
Name:ROYBAL, DAYNA RHAE (RN)
Entity type:Individual
Prefix:
First Name:DAYNA
Middle Name:RHAE
Last Name:ROYBAL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 CARSON AVE
Mailing Address - Street 2:
Mailing Address - City:LA JUNTA
Mailing Address - State:CO
Mailing Address - Zip Code:81050-2227
Mailing Address - Country:US
Mailing Address - Phone:719-691-3037
Mailing Address - Fax:
Practice Address - Street 1:30999 COUNTY ROAD 15
Practice Address - Street 2:
Practice Address - City:LAS ANIMAS
Practice Address - State:CO
Practice Address - Zip Code:81054-9499
Practice Address - Country:US
Practice Address - Phone:719-662-1101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-30
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0197193163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse