Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | APRN955 | HI |
NPI | 1053486035 |
---|---|
Provider Name | Joan M. Maeshiro |
First Address | Honolulu, HI 96820-2040 |
Second Address | Honolulu, HI 96813-2414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2006 |
Last Update Date | 16/11/2016 |