Provider Demographics
NPI:1003455304
Name:SEBOK, RUTH MARILYN
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:MARILYN
Last Name:SEBOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-2234
Mailing Address - Country:US
Mailing Address - Phone:808-738-6084
Mailing Address - Fax:
Practice Address - Street 1:651 11TH AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-2234
Practice Address - Country:US
Practice Address - Phone:808-738-6084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI94308163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool