Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | APRN-726 | HI |
NPI | 1053464636 |
---|---|
Provider Name | Joyce A Madonia |
First Address | Honolulu, HI 96819-1469 |
Second Address | Honolulu, HI 96819-1469 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000253344 | HMSA BILLING NUMBER (01) | HI |