Provider Demographics
NPI:1689451759
Name:RAFOLS, JEZRELLE CARAS (NP)
Entity Type:Individual
Prefix:
First Name:JEZRELLE
Middle Name:CARAS
Last Name:RAFOLS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WAILEA IKE DR
Mailing Address - Street 2:
Mailing Address - City:WAILEA
Mailing Address - State:HI
Mailing Address - Zip Code:96753-9514
Mailing Address - Country:US
Mailing Address - Phone:808-281-6580
Mailing Address - Fax:
Practice Address - Street 1:100 WAILEA IKE DR
Practice Address - Street 2:
Practice Address - City:WAILEA
Practice Address - State:HI
Practice Address - Zip Code:96753-9514
Practice Address - Country:US
Practice Address - Phone:808-281-6580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-4238-0363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily