Individual
MARY JANE ROMONA HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
480 CENTRAL AVE, BLDG 1750, RM 158A, JBPHH, HI 96860-4908
(888) 888-8888
Mailing address
1617 AUPUNI ST, APT K, HONOLULU, HI 96817-1980
(808) 349-7902
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
6821
HI
Other
Enumeration date
12/26/2012
Last updated
12/26/2012
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