Nina Myra Badua, CNA

Individual provider Active NPI Adult Care Home Facility · Ewa Beach, HI

NPI 1144827148 · NPPES record last updated Oct 3, 2020

Key facts

NPI
1144827148
Entity type
Individual (NPI type 1)
Primary specialty
Adult Care Home Facility 311ZA0620X
License
1-190044 (HI)
Practice address
91-1307 Maliko St
Ewa Beach, HI 96706-1809
Phone
(808) 729-6560
Fax
(808) 681-3383
NPI assigned
Oct 3, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1-190044HIMDAdult Care Home Facility

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 1-190044 HI Yes

Addresses

Primary practice location

91-1307 Maliko St
Ewa Beach, HI 96706-1809

Mailing address

91-1307 Maliko St
Ewa Beach, HI 96706-1809
Phone (808) 729-6560

Other identifiers

IdentifierTypeStateIssuer
1-190044OtherHIDOH OHCA
2027619OtherHIOHANA WELLCARE

Other providers in Ewa Beach, HI

All providers in Ewa Beach, HI · Adult Care Home Facility in Hawaii

Sources for this page

Verify at the official NPI Registry.