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Individual

MS. PHYLAVANH PHANHTHARATH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ACNS-BC

Contact information

Practice address
1190 WAIANUENUE AVE, HILO, HI 96720-2094
(808) 932-3000
Mailing address
1190 WAIANUENUE AVE, HILO, HI 96720-2094
(808) 932-3000

Taxonomy

Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
AP133384
TX
364SA2200X
Adult Health Clinical Nurse Specialist
APRN-2756
HI

Other

Enumeration date
04/06/2017
Last updated
08/14/2020
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