Mary Theresa Self, RN

Primary specialty

Pediatric Registered NurseTaxonomy code 163WP0200X

License

65441 Issued in HI

Practice address

1651 Mott-Smith Dr Apt D
Honolulu, HI 96822-2802

Phone

(808) 202-1534

NPI assigned

Apr 18, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1114580826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 MOTT-SMITH DR APT D",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968222802",
            "telephone_number": "808-202-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 MOTT-SMITH DR APT D",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968222802",
            "telephone_number": "808-202-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "MARY",
        "middle_name": "THERESA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "HI",
            "license": "65441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Paul Sekulich, MPT
• Coren B Sekulich, PT
• Anne Selby
• Select Speech Services LLC
• Self Help Hawaii, LLC
• Matthew Selle, RN
• Marilia Selli, MFT
• John M Semenza II, MD
• John M Semenza, MD
• Rina Grace Seminoff

• Pediatric Registered Nurse in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Pediatric Registered Nurse in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.

Verify at the official NPI Registry.