Provider Demographics
NPI:1134548944
Name:CABUYADAO, RELLY PACRIS (CNA)
Entity type:Individual
Prefix:MRS
First Name:RELLY
Middle Name:PACRIS
Last Name:CABUYADAO
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2177B AWAPUHI ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-6534
Mailing Address - Country:US
Mailing Address - Phone:808-315-7118
Mailing Address - Fax:808-315-7118
Practice Address - Street 1:2177B AWAPUHI ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-6534
Practice Address - Country:US
Practice Address - Phone:808-315-7118
Practice Address - Fax:808-315-7118
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIHI040906287376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide