Provider Demographics
NPI:1477118156
Name:NUNEZ, RICARDO (RN)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:NUNEZ
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 PAPAKAPU PL
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1513
Mailing Address - Country:US
Mailing Address - Phone:415-377-3836
Mailing Address - Fax:
Practice Address - Street 1:335 S PAPA AVE
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-1528
Practice Address - Country:US
Practice Address - Phone:808-757-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN-93015163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse