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General NPI Number Information
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NPI Number | 1851199970
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Entity Type | Individual
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Provider Name | JANVER TAYGON FUDOLIG RN
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Gender | Male
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 459 PATTERSON RD
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City | HONOLULU
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State | HI
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Zip | 96819-1522
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Country | US
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Telephone | 808-835-9676
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Fax |
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Provider Business Mailing Address
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Address Line | 73-5618 MAIAU ST STE C200
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City | KAILUA KONA
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State | HI
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Zip | 96740-2635
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Country | US
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Telephone | 808-835-9676
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN-80766
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License Number State | HI
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