Individual
MRS. CAMERON L JAKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
480 CENTRAL AVE, PEARL HARBOR, HI 96860-4908
(808) 471-1866
Mailing address
480 CENTRAL AVE, JBPHH, HI 96860-4908
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
17140
HI
Other
Enumeration date
05/15/2013
Last updated
05/15/2013
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