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General NPI Number Information
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NPI Number | 1316055882
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Entity Type | Individual
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Provider Name | DOREEN ANN DETUCCI RN
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Gender | Female
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Dates
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Enumeration Date | 08/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | KAUAI COMMUNITY MENTAL HEALTH CENTER 3 3212 KUHIO HWY
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City | LIHUE
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State | HI
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Zip | 96766-1142
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Country | US
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Telephone | 808-274-3190
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Fax | 808-274-3194
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Provider Business Mailing Address
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Address Line | KAUAI COMMUNITY MENTAL HEALTH CENTER 3 3212 KUHIO HWY
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City | LIHUE
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State | HI
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Zip | 96766-1142
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Country | US
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Telephone | 808-274-3190
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Fax | 808-274-3194
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN-56769
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License Number State | HI
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