Provider Demographics
NPI:1750635371
Name:INOCENCIO, BEVERLY LAURON GABOYA (ACNP-BC, CCRN, CEN)
Entity Type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:LAURON GABOYA
Last Name:INOCENCIO
Suffix:
Gender:F
Credentials:ACNP-BC, CCRN, CEN
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE 705
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5212
Mailing Address - Country:US
Mailing Address - Phone:808-551-6782
Mailing Address - Fax:
Practice Address - Street 1:1301 PUNCHBOWL ST
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2402
Practice Address - Country:US
Practice Address - Phone:808-551-6782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-05
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI1601363LA2100X
TX639381363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1601OtherHAWAII APRN-RX LICENSE