Provider Demographics
NPI:1235596560
Name:ROUSEK, RINA KOJIMA (APRN)
Entity Type:Individual
Prefix:
First Name:RINA
Middle Name:KOJIMA
Last Name:ROUSEK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:RINA
Other - Middle Name:
Other - Last Name:KOJIMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:2180 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1625
Mailing Address - Country:US
Mailing Address - Phone:808-242-6464
Mailing Address - Fax:808-984-7445
Practice Address - Street 1:55 PUKALANI ST
Practice Address - Street 2:
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-8544
Practice Address - Country:US
Practice Address - Phone:808-242-6464
Practice Address - Fax:808-984-7445
Is Sole Proprietor?:No
Enumeration Date:2016-01-18
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-3157363L00000X
NE111953363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner