Jenny-Lyn Simeon Agag
Individual provider Active NPI Registered Nurse · Waipahu, HI
NPI 1295326478 · NPPES record last updated Jan 29, 2021
Key facts
- NPI
- 1295326478
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN-84229 (HI)
- Practice address
- 94-1125 Limahana St
Waipahu, HI 96797-3740 - Phone
- (808) 497-7175
- NPI assigned
- Jan 29, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN-84229 | HI | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN-84229 | HI | Yes |
Addresses
Primary practice location
94-1125 Limahana St
Waipahu, HI 96797-3740
Mailing address
94-1125 Limahana St
Waipahu, HI 96797-3740
Phone (808) 497-7175
Other names
- Jenny-Lyn Tagalicud Simeon
Other providers in Waipahu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.