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General NPI Number Information
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NPI Number | 1891136131
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Entity Type | Organization
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Legal Business Name | ADVENT HEALTHCARE & WELLNESS INC.
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Dates
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Enumeration Date | 07/15/2013
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Last Update Date | 07/15/2013
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Provider Practice Location Address
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Address Line | 2964 IOLANI ST
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City | MAKAWAO
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State | HI
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Zip | 96768-8531
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Country | US
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Telephone | 808-359-1641
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Fax |
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Provider Business Mailing Address
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Address Line | 2964 IOLANI ST
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City | MAKAWAO
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State | HI
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Zip | 96768-8531
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Country | US
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Telephone | 808-359-1641
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. GINA IRENE PUEN
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Credential | APRN
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Telephone | 808-359-1641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 1420
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License Number State | HI
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