Provider Demographics
NPI:1053330076
Name:LOCQUIAO, MADELYN G (NP)
Entity Type:Individual
Prefix:
First Name:MADELYN
Middle Name:G
Last Name:LOCQUIAO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MADELYN
Other - Middle Name:Y
Other - Last Name:GAMPONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:45-480 KANEOHE BAY DR
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2039
Mailing Address - Country:US
Mailing Address - Phone:808-261-8537
Mailing Address - Fax:
Practice Address - Street 1:45 480 KANEOHE BAY DRIVE
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-2039
Practice Address - Country:US
Practice Address - Phone:808-235-5805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-283363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000220160OtherHMSA PROVIDER NUMBER
HI53787102Medicaid
HIP01373Medicare UPIN
HIH56728Medicare PIN