Provider Demographics
NPI:1477102564
Name:ESLAVA, ALIXIS CHANTEL MUNOZ (RN)
Entity Type:Individual
Prefix:
First Name:ALIXIS CHANTEL
Middle Name:MUNOZ
Last Name:ESLAVA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92-443 KAIAULU ST
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1034
Mailing Address - Country:US
Mailing Address - Phone:808-295-3428
Mailing Address - Fax:
Practice Address - Street 1:92-443 KAIAULU ST
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-1034
Practice Address - Country:US
Practice Address - Phone:808-295-3428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI94744163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse