Maribelle Agustin
Individual provider Active NPI Registered Nurse · Ewa Beach, HI
NPI 1508230723 · NPPES record last updated Nov 26, 2015
Key facts
- NPI
- 1508230723
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN-72628 (HI)
- Practice address
- 91-949 Ikulani St
Ewa Beach, HI 96706-2207 - Phone
- (808) 744-8510
- Fax
- (808) 744-8510
- NPI assigned
- Nov 26, 2015
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| RN-72628 | HI | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN-72628 | HI | Yes |
Addresses
Primary practice location
91-949 Ikulani St
Ewa Beach, HI 96706-2207
Mailing address
91-949 Ikulani St
Ewa Beach, HI 96706-2207
Phone (808) 744-8510
Other providers in Ewa Beach, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2015. 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.