Healthcare Provider Details

I. General information

NPI: 1194389940
Provider Name (Legal Business Name): SHARMAINE HEALOHA YACAVONE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2019
Last Update Date: 04/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95-118 LOKALIA PL
MILILANI HI
96789-3730
US

IV. Provider business mailing address

95-118 LOKALIA PL
MILILANI HI
96789-3730
US

V. Phone/Fax

Practice location:
  • Phone: 808-392-0832
  • Fax:
Mailing address:
  • Phone: 808-392-0832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number88147
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: