Individual
ALLYSA CHANTEL BAXLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2134 KOLEKOLE AVE, WAHIAWA, HI 96786-7028
(931) 241-0497
Mailing address
2134 KOLEKOLE AVE, WAHIAWA, HI 96786-7028
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
19774
HI
Other
Enumeration date
01/03/2020
Last updated
01/03/2020
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