Provider Demographics
NPI:1669009155
Name:SOLIVEN, LORYTESS ABLAO (FNP)
Entity Type:Individual
Prefix:
First Name:LORYTESS
Middle Name:ABLAO
Last Name:SOLIVEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LORYTESS
Other - Middle Name:DELA PENA
Other - Last Name:ABLAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:32 KUUHALE PL
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-3130
Mailing Address - Country:US
Mailing Address - Phone:808-633-6677
Mailing Address - Fax:
Practice Address - Street 1:2850 W HORIZON RIDGE PKWY STE 140
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4395
Practice Address - Country:US
Practice Address - Phone:805-719-3700
Practice Address - Fax:805-413-9099
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-24
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIF01201868364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health