Individual
VICKIE MARIE FACHINELLI PORTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,C.N.P
Contact information
Practice address
16-192 PILI MUA ST, KEAAU, HI 96749-8134
(808) 333-3600
Mailing address
75-5751 KUAKINI HWY STE 203, KAILUA KONA, HI 96740-1753
(808) 333-3600
(808) 961-5167
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
APRN-2904
HI
363LP0200X
Pediatric Nurse Practitioner
R1399752
MN
Other
Enumeration date
08/06/2008
Last updated
07/19/2022
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