Provider Demographics
NPI:1689220238
Name:PREPUSE, SHEILLAMARI AFRICA (RN)
Entity Type:Individual
Prefix:
First Name:SHEILLAMARI
Middle Name:AFRICA
Last Name:PREPUSE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86-218 LEIHOKU ST
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-2957
Mailing Address - Country:US
Mailing Address - Phone:808-744-1517
Mailing Address - Fax:808-744-1517
Practice Address - Street 1:86-218 LEIHOKU ST
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-2957
Practice Address - Country:US
Practice Address - Phone:808-744-1517
Practice Address - Fax:808-744-1517
Is Sole Proprietor?:No
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI77835163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice