Individual
MRS. JODY ANN MAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
91-2301 OLD FT WEAVER RD, EWA BEACH, HI 96706-3602
(808) 677-2525
(808) 677-2570
Mailing address
91-1175 KUANOO ST, EWA BEACH, HI 96706-4634
(808) 220-1942
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
39439
HI
Other
Enumeration date
07/30/2009
Last updated
07/30/2009
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