Individual
MRS. CAROL LYNN VELASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM, CPM
Contact information
Practice address
4620 HAUAALA RD, KAPAA, HI 96746-1811
(803) 443-5163
Mailing address
4620 HAUAALA RD, KAPAA, HI 96746-1811
(803) 443-5163
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
06110002
TN
176B00000X
Midwife
LMW-0053
SC
176B00000X
Midwife
Primary
MW-25
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MW-25
LICENSE NUMBER
HI
01
—
MW-25-0
HAWAII LICENSE
HI
Enumeration date
11/18/2008
Last updated
08/15/2022
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