Provider Demographics
NPI:1740783273
Name:GARCIA, JENEAN NOELANI (APRN)
Entity Type:Individual
Prefix:
First Name:JENEAN
Middle Name:NOELANI
Last Name:GARCIA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 MAA ST
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-3603
Mailing Address - Country:US
Mailing Address - Phone:808-446-7120
Mailing Address - Fax:808-446-7121
Practice Address - Street 1:165 MAA ST
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-3603
Practice Address - Country:US
Practice Address - Phone:808-446-7120
Practice Address - Fax:808-446-7121
Is Sole Proprietor?:No
Enumeration Date:2018-03-12
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI66003163W00000X
HI1745363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse