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General NPI Number Information
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NPI Number | 1821619156
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Entity Type | Individual
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Provider Name | RESURRECCION BUMANGLAG BUAN CNA
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Gender | Female
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Dates
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Enumeration Date | 04/28/2020
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Last Update Date | 04/28/2020
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Provider Practice Location Address
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Address Line | 91-1044 UOUOA ST
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City | EWA BEACH
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State | HI
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Zip | 96706-3593
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Country | US
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Telephone | 808-223-6497
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Fax | 808-671-1726
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Provider Business Mailing Address
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Address Line | 91-1044 UOUOA ST
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City | EWA BEACH
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State | HI
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Zip | 96706-3593
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Country | US
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Telephone | 808-223-6497
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Fax | 808-671-1726
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 1-100030
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License Number State | HI
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