Individual
JARED MEDEIROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
478 LAUHALA PLACE, LANAI CITY, HI 96763
(808) 565-6919
(808) 565-9111
Mailing address
PO BOX 630142, LANAI CITY, HI 96763-0142
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN-1845
HI
Other
Enumeration date
12/04/2014
Last updated
12/04/2014
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