Provider Demographics
NPI:1598726861
Name:JEWELL, MARY PATRICIA (CNM)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:PATRICIA
Last Name:JEWELL
Suffix:
Gender:F
Credentials:CNM
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Mailing Address - Street 1:642 ULUKAHIKI ST
Mailing Address - Street 2:STE 209
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4439
Mailing Address - Country:US
Mailing Address - Phone:808-230-8500
Mailing Address - Fax:808-230-8501
Practice Address - Street 1:642 ULUKAHIKI ST
Practice Address - Street 2:STE 209
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4439
Practice Address - Country:US
Practice Address - Phone:808-230-8500
Practice Address - Fax:808-230-8501
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2014-07-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GU367A00000X
HIAPRN-1076367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife