Provider Demographics
NPI:1972156933
Name:FELLOWS, MARGARET MAXENE
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:MAXENE
Last Name:FELLOWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3271 KEHAU PL APT D
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-6204
Mailing Address - Country:US
Mailing Address - Phone:808-754-1487
Mailing Address - Fax:
Practice Address - Street 1:3271 KEHAU PL APT D
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-6204
Practice Address - Country:US
Practice Address - Phone:808-754-1487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI92428163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse