Individual
ANDREW CLARK SOBREPENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2501 WAIMANO HOME RD, PEARL CITY, HI 96782-1478
(808) 454-1411
(808) 454-0659
Mailing address
PO BOX 1196, PEARL CITY, HI 96782-8196
(808) 454-1411
(808) 454-0659
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN-114502
HI
Other
Enumeration date
08/12/2024
Last updated
08/12/2024
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