Individual
MARIENNE VILLANUEVA VERGARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
91-896 OANIANI ST, KAPOLEI, HI 96707-2644
(808) 542-6077
Mailing address
91-896 OANIANI ST, KAPOLEI, HI 96707-2644
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10373
HI
Other
Enumeration date
07/12/2019
Last updated
07/12/2019
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