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NPI Code Detail

MEDICARE: XAVIER R DURNELL

MEDICARE: XAVIER R DURNELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health Worker172V00000

General Provider Information

NPI Number : 1740114602
Entity Type Code : Individual
Provider Name (Legal Business Name) : XAVIER R DURNELL
Provider Business Mailing Address
First Line : 91-1043 AUKAHI ST
Second Line :
City : KAPOLEI
State : HI
Zip : 96707-1997
Country : US
Telephone Number : 808-681-1419
Fax Number : 808-681-1486
Provider Business Practice Location Address
First Line : 91-1841 FORT WEAVER RD
Second Line :
City : EWA BEACH
State : HI
Zip : 96706-1909
Country : US
Telephone Number : 808-681-1419
Fax Number : 808-681-1486
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2026
Last Update Date : 06/08/2026

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Directions to “ XAVIER R DURNELL ” Practice Location

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