Individual
ALYSSA MARIE DERHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1240 ALA KAPUNA ST APT 309, HONOLULU, HI 96819-4612
(831) 524-6381
Mailing address
1240 ALA KAPUNA ST APT 309, HONOLULU, HI 96819-4612
(831) 524-6381
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
19707
HI
Other
Enumeration date
11/12/2019
Last updated
11/12/2019
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