1730676347 NPI number — MR. JONATHAN UMIPIG FELARCA APRN-RX

Table of content: MR. JONATHAN UMIPIG FELARCA APRN-RX (NPI 1730676347)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730676347 NPI number — MR. JONATHAN UMIPIG FELARCA APRN-RX

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FELARCA
Provider First Name:
JONATHAN
Provider Middle Name:
UMIPIG
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
APRN-RX
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FELARCA
Provider Other First Name:
JON
Provider Other Middle Name:
UMIPIG
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
APRN-RX
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1730676347
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/18/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
840 KAKALA ST APT 306
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KAPOLEI
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96707-4608
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-551-8191
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1301 PUNCHBOWL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-2499
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-691-1000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/18/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  RN-63020 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2100X , with the licence number: APRN-2430 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: APRN-2430 . This is a "HAWAII BOARD OF NURSING" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".