Provider Demographics
NPI:1669350815
Name:AYALA, RAUL ISRAEL I
Entity type:Individual
Prefix:
First Name:RAUL
Middle Name:ISRAEL
Last Name:AYALA
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 13TH ST
Mailing Address - Street 2:
Mailing Address - City:GERING
Mailing Address - State:NE
Mailing Address - Zip Code:69341-3256
Mailing Address - Country:US
Mailing Address - Phone:308-765-7008
Mailing Address - Fax:
Practice Address - Street 1:1400 P ST
Practice Address - Street 2:
Practice Address - City:GERING
Practice Address - State:NE
Practice Address - Zip Code:69341-2749
Practice Address - Country:US
Practice Address - Phone:308-641-4364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE000000000372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider