Provider Demographics
NPI:1427384064
Name:ALBANO, LIBERTY QUIROGA (CNA)
Entity Type:Individual
Prefix:MRS
First Name:LIBERTY
Middle Name:QUIROGA
Last Name:ALBANO
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16-530 OHE ST
Mailing Address - Street 2:
Mailing Address - City:KEAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96749-8109
Mailing Address - Country:US
Mailing Address - Phone:808-982-9210
Mailing Address - Fax:
Practice Address - Street 1:16-530 OHE ST
Practice Address - Street 2:
Practice Address - City:KEAAU
Practice Address - State:HI
Practice Address - Zip Code:96749-8109
Practice Address - Country:US
Practice Address - Phone:808-982-9210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-01
Last Update Date:2009-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI376K00000X376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide