Provider Demographics
NPI:1013162486
Name:MAGANA, VITAE TRILLES (RN)
Entity Type:Individual
Prefix:MRS
First Name:VITAE
Middle Name:TRILLES
Last Name:MAGANA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-1051 FRANKLIN D . ROOSEVELT AVENUE
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707
Mailing Address - Country:US
Mailing Address - Phone:808-458-5065
Mailing Address - Fax:
Practice Address - Street 1:91-1051 FRANKLIN D ROOSEVELT AVENUE
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707
Practice Address - Country:US
Practice Address - Phone:808-458-5065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-25
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN60932163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care