Provider Demographics
NPI:1689239345
Name:ALEXANDER, REBECCA J (RN)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:J
Last Name:ALEXANDER
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:PO BOX 881202
Mailing Address - Street 2:
Mailing Address - City:PUKALANI
Mailing Address - State:HI
Mailing Address - Zip Code:96788-1202
Mailing Address - Country:US
Mailing Address - Phone:808-298-1656
Mailing Address - Fax:
Practice Address - Street 1:335 S PAPA AVE
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-1528
Practice Address - Country:US
Practice Address - Phone:808-298-1656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI28748163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse