Provider Demographics
NPI:1497388060
Name:PARESA, CHANEL KAPUALEIALOHA (APRN-RX)
Entity Type:Individual
Prefix:
First Name:CHANEL
Middle Name:KAPUALEIALOHA
Last Name:PARESA
Suffix:
Gender:F
Credentials:APRN-RX
Other - Prefix:
Other - First Name:CHANEL
Other - Middle Name:PARESA
Other - Last Name:DALUDDUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:95-230 HALEPULE PL
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-6579
Mailing Address - Country:US
Mailing Address - Phone:808-295-5252
Mailing Address - Fax:
Practice Address - Street 1:95-230 HALEPULE PL
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-6579
Practice Address - Country:US
Practice Address - Phone:808-295-5252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-21
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10016974363LF0000X
NM73586363LF0000X
HI3508363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily