Healthcare Provider Details

I. General information

NPI: 1467267864
Provider Name (Legal Business Name): FIAPITO FELETI VIMOTO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1005
PAGO PAGO AS
96799-1005
US

IV. Provider business mailing address

PO BOX 5893
PAGO PAGO AS
96799-5893
US

V. Phone/Fax

Practice location:
  • Phone: 684-699-3730
  • Fax: 684-699-3371
Mailing address:
  • Phone: 684-782-4040
  • Fax: 684-699-3371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1116A
License Number StateAS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: