Provider Demographics
NPI:1609502897
Name:BASILIO, SHARMAINE ROSE C
Entity Type:Individual
Prefix:
First Name:SHARMAINE ROSE
Middle Name:C
Last Name:BASILIO
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 1:98-259 HEKAHA ST
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-5211
Mailing Address - Country:US
Mailing Address - Phone:808-397-9170
Mailing Address - Fax:
Practice Address - Street 1:98-259 HEKAHA ST
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-5211
Practice Address - Country:US
Practice Address - Phone:808-397-9170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty