Healthcare Provider Details

I. General information

NPI: 1831841006
Provider Name (Legal Business Name): PAULA NICHAELLE EXCONDE AQUINO MSN, APRN-RX, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2022
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-837 WAIPAHU ST
WAIPAHU HI
96797-3320
US

IV. Provider business mailing address

91-1200 KEAUNUI DR APT 1
EWA BEACH HI
96706-4698
US

V. Phone/Fax

Practice location:
  • Phone: 808-671-3911
  • Fax:
Mailing address:
  • Phone: 808-724-8156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-3591
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-3591
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN-3591
License Number StateHI
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-95446
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: