Provider Demographics
NPI:1821320060
Name:YASAY, MELODY (NURSES AIDE)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:
Last Name:YASAY
Suffix:
Gender:F
Credentials:NURSES AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 WAWE PL
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-1943
Mailing Address - Country:US
Mailing Address - Phone:808-845-9707
Mailing Address - Fax:808-845-9707
Practice Address - Street 1:1303 WAWE PL
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96818-1943
Practice Address - Country:US
Practice Address - Phone:808-845-9707
Practice Address - Fax:808-845-9707
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIN535096OtherWELLCARE PROVIDER ID