Individual
PAULLA DEMELLO-O'BANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
79-1020 HAUKAPILA ST, KEALAKEKUA, HI 96750-7922
(808) 322-4818
(808) 322-4817
Mailing address
PO BOX 390940, KEAUHOU, HI 96739-0940
(808) 896-5064
(808) 322-4817
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
539372-18
—
HI
Enumeration date
05/14/2008
Last updated
05/14/2008
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