Provider Demographics
NPI:1568530632
Name:SCHREIBER, ROSALIE JEAN (APRN)
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:JEAN
Last Name:SCHREIBER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1203
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-1203
Mailing Address - Country:US
Mailing Address - Phone:808-385-0199
Mailing Address - Fax:
Practice Address - Street 1:39 W KAMEHAMEHA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2263
Practice Address - Country:US
Practice Address - Phone:808-877-2424
Practice Address - Fax:808-877-6464
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN24680163W00000X
HIAPRN848363LW0102X
OR200850040NP363LA2200X, 363L00000X
HI848363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI577918Medicare UPIN