Provider Demographics
NPI:1497801369
Name:GUE, CECILIA M (CNS)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:M
Last Name:GUE
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:CECILIA
Other - Middle Name:M
Other - Last Name:GORDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2828 PAA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-4405
Mailing Address - Country:US
Mailing Address - Phone:808-432-5770
Mailing Address - Fax:
Practice Address - Street 1:2828 PAA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-4405
Practice Address - Country:US
Practice Address - Phone:808-432-5770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-136364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI55329901Medicaid
HI55329901Medicaid
HIP05319Medicare UPIN