Individual
MRS. JANE BADUA IDICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
480 CENTRAL AVE, PEARL HARBOR, HI 96860-4908
(808) 674-7819
Mailing address
480 CENTRAL AVE, PEARL HARBOR, HI 96860-4908
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
41327
HI
Other
Enumeration date
08/12/2022
Last updated
08/30/2022
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