Healthcare Provider Details

I. General information

NPI: 1366585358
Provider Name (Legal Business Name): PAMELA CUARISMA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 KEKAULIKE ST
HILO HI
96720-2462
US

IV. Provider business mailing address

119 PEEPEE WAY
HILO HI
96720-1262
US

V. Phone/Fax

Practice location:
  • Phone: 808-974-4300
  • Fax: 808-974-4310
Mailing address:
  • Phone: 808-935-2333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN - 31749
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: