Provider Demographics
NPI:1316023740
Name:LESNETT, CAROLYN M (APRN)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:M
Last Name:LESNETT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W KAWILI ST
Mailing Address - Street 2:CAMPUS CENTER 212
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4075
Mailing Address - Country:US
Mailing Address - Phone:808-974-7636
Mailing Address - Fax:808-933-0868
Practice Address - Street 1:200 W KAWILI ST
Practice Address - Street 2:CAMPUS CENTER 212
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4075
Practice Address - Country:US
Practice Address - Phone:808-974-7636
Practice Address - Fax:808-933-0868
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI17627163WC1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI21767-9OtherHMSA PROVIDER NUMBER