Individual
JACQUELINE DENISE RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
14-3335 MAYZEE RD # 2314, PAHOA, HI 96778-8171
(808) 365-2683
Mailing address
14-3335 MAYZEE RD # 2314, PAHOA, HI 96778-8171
(808) 365-2683
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
16755
HI
Other
Enumeration date
06/27/2019
Last updated
06/27/2019
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