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General NPI Number Information
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NPI Number | 1811034994
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Entity Type | Individual
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Provider Name | MARIVYN AURELIO CASINO C.N.A
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Gender | Female
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 91-1035 OPAEHUNA ST
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City | EWA BEACH
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State | HI
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Zip | 96706-3566
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Country | US
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Telephone | 808-677-5805
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Fax | 808-671-5591
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Provider Business Mailing Address
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Address Line | 91-1035 OPAEHUNA ST
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City | EWA BEACH
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State | HI
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Zip | 96706-3566
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Country | US
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Telephone | 808-677-5805
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Fax | 808-671-5591
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 121917970690F
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License Number State | HI
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