IndividualActive
Idriss Ayelara
NPI 1720715303 · Gerontology Registered Nurse · Detroit, MI
Provider details
- NPI number
- 1720715303
- Entity type
- Individual
- Primary specialty
- Gerontology Registered NurseNursing Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 2011000692 (MO)
Specialties & taxonomies
Nursing Service Providers
Practice location
4646 John R St
Detroit, MI 48201-1916
Phone: (313) 576-1000
Approximate (ZIP-level) locationGet directions
Mailing address
4646 John R St
Detroit, MI 48201-1916
Registry dates
- Enumerated
- 2022-08-04
- Last updated
- 2022-08-04
- Certified
- 2022-08-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.