Active NPI
Maylene Bornales Agnes
- Registered Nurse
- Pearl City, HI
National Provider Identifier
1114570496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 93676
- Practice address
- 1265 Noelani St
Pearl City, HI 96782-2158 - Phone
- (808) 376-6828
- NPI assigned
- Jul 16, 2019
- Last updated
- Jul 16, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 93676 | HI | Primary |
Addresses
Primary practice location
1265 Noelani St
Pearl City, HI 96782-2158
Mailing address
1265 Noelani St
Pearl City, HI 96782-2158
Phone (808) 376-6828
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 93676 | HI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563235200000",
"number": "1114570496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1265 NOELANI ST",
"city": "PEARL CITY",
"state": "HI",
"postal_code": "967822158",
"telephone_number": "808-376-6828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1265 NOELANI ST",
"city": "PEARL CITY",
"state": "HI",
"postal_code": "967822158",
"telephone_number": "808-376-6828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGNES",
"first_name": "MAYLENE",
"middle_name": "BORNALES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-16",
"last_updated": "2019-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "HI",
"license": "93676",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pearl City, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.