Provider Demographics
NPI:1568028199
Name:ALVARADO, METODIA BELLA MARIE
Entity Type:Individual
Prefix:
First Name:METODIA
Middle Name:BELLA MARIE
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 814 HANALEI STREET
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-1918
Mailing Address - Country:US
Mailing Address - Phone:808-285-9561
Mailing Address - Fax:
Practice Address - Street 1:89 980 NANAKULI AVENUE
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-1918
Practice Address - Country:US
Practice Address - Phone:808-668-5823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN48123163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics