Healthcare Provider Details

I. General information

NPI: 1043455926
Provider Name (Legal Business Name): JASMINE MICHELLE MAES LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2008
Last Update Date: 08/08/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5820 MELI PL
KAPAA HI
96746-2326
US

IV. Provider business mailing address

5820 MELI PL
KAPAA HI
96746-2326
US

V. Phone/Fax

Practice location:
  • Phone: 808-212-8006
  • Fax: 808-204-9988
Mailing address:
  • Phone: 808-212-8006
  • Fax: 808-204-9988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW14
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: