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General NPI Number Information
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NPI Number | 1689451759
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Entity Type | Individual
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Provider Name | JEZRELLE CARAS RAFOLS NP
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Gender | Female
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Dates
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Enumeration Date | 09/12/2023
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 100 WAILEA IKE DR
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City | WAILEA
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State | HI
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Zip | 96753-9514
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Country | US
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Telephone | 808-281-6580
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Fax |
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Provider Business Mailing Address
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Address Line | 100 WAILEA IKE DR
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City | WAILEA
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State | HI
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Zip | 96753-9514
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Country | US
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Telephone | 808-281-6580
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN-4238-0
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License Number State | HI
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