Healthcare Provider Details

I. General information

NPI: 1841022357
Provider Name (Legal Business Name): US NAVAL HOSPITAL OKINAWA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2024
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 FUTENMA
GINOWAN OKINAWA
9012202
JP

IV. Provider business mailing address

PSC 482 BOX 2954
FPO AP
96362-0030
US

V. Phone/Fax

Practice location:
  • Phone: 315-646-3628
  • Fax:
Mailing address:
  • Phone: 619-657-5857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MRS. DAYANE CRISTINA PIRES MESADRI
Title or Position: NURSE CASE MANAGER
Credential: RN
Phone: 619-657-5857