Provider Demographics
NPI:1821859158
Name:ROBY, RANI NICOLE
Entity Type:Individual
Prefix:
First Name:RANI
Middle Name:NICOLE
Last Name:ROBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RANI
Other - Middle Name:NICOLE
Other - Last Name:MADDOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13-1248 KAHUKAI ST
Mailing Address - Street 2:
Mailing Address - City:PAHOA
Mailing Address - State:HI
Mailing Address - Zip Code:96778-8200
Mailing Address - Country:US
Mailing Address - Phone:970-381-7319
Mailing Address - Fax:
Practice Address - Street 1:13-1248 KAHUKAI ST
Practice Address - Street 2:
Practice Address - City:PAHOA
Practice Address - State:HI
Practice Address - Zip Code:96778-8200
Practice Address - Country:US
Practice Address - Phone:970-381-7319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care