Provider Demographics
NPI:1093066631
Name:FALE, DOROTHY FAYE (FNP)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:FAYE
Last Name:FALE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92-830 KINOHI PL APT 1
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1305
Mailing Address - Country:US
Mailing Address - Phone:808-397-3406
Mailing Address - Fax:
Practice Address - Street 1:92-830 KINOHI PL APT 1
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-1305
Practice Address - Country:US
Practice Address - Phone:808-397-3406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-23
Last Update Date:2012-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN 1490363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily