Healthcare Provider Details

I. General information

NPI: 1376312843
Provider Name (Legal Business Name): CHENOAH LIN COUVILLION NIGRELLI MS, ATC, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2023
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91-5007 KAPOLEI PKWY
KAPOLEI HI
96707-3201
US

IV. Provider business mailing address

66-615 KAMEHAMEHA HWY
HALEIWA HI
96712-1428
US

V. Phone/Fax

Practice location:
  • Phone: 808-777-0857
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number130667
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT-91-0
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: