Provider Demographics
NPI:1609672732
Name:VAIL, TRAJUANA
Entity type:Individual
Prefix:
First Name:TRAJUANA
Middle Name:
Last Name:VAIL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 OAK HILL CT
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2593
Mailing Address - Country:US
Mailing Address - Phone:419-901-0880
Mailing Address - Fax:
Practice Address - Street 1:1435 OAK HILL CT
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2593
Practice Address - Country:US
Practice Address - Phone:419-901-0880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide