Provider Demographics
NPI:1730676347
Name:FELARCA, JONATHAN UMIPIG (APRN-RX)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:UMIPIG
Last Name:FELARCA
Suffix:
Gender:M
Credentials:APRN-RX
Other - Prefix:MR
Other - First Name:JON
Other - Middle Name:UMIPIG
Other - Last Name:FELARCA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN-RX
Mailing Address - Street 1:840 KAKALA ST APT 306
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-4608
Mailing Address - Country:US
Mailing Address - Phone:808-551-8191
Mailing Address - Fax:
Practice Address - Street 1:1301 PUNCHBOWL ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2499
Practice Address - Country:US
Practice Address - Phone:808-691-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN-63020163W00000X
HIAPRN-2430363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIAPRN-2430OtherHAWAII BOARD OF NURSING