Provider Demographics
NPI:1245742030
Name:GREEN, CECILIA LEILA ALOMIA (APRN)
Entity Type:Individual
Prefix:
First Name:CECILIA LEILA
Middle Name:ALOMIA
Last Name:GREEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CECILIA LEILA
Other - Middle Name:ALOMIA
Other - Last Name:ABOU EL ELA ALI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1650 ALA MOANA BLVD APT 1109
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-1410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:94-229 WAIPAHU DEPOT ST STE 101
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3032
Practice Address - Country:US
Practice Address - Phone:808-206-9849
Practice Address - Fax:808-206-9850
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2227363LF0000X
HI70929163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse