Provider Demographics
NPI:1205937141
Name:DELLA, ROSALINA (APRN)
Entity type:Individual
Prefix:
First Name:ROSALINA
Middle Name:
Last Name:DELLA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 KUALA ST STE 103
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-3900
Mailing Address - Country:US
Mailing Address - Phone:808-456-2273
Mailing Address - Fax:808-456-2274
Practice Address - Street 1:890 KAMOKILA BLVD STE 102
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2022
Practice Address - Country:US
Practice Address - Phone:808-784-2273
Practice Address - Fax:808-784-2274
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY368867-1163W00000X
AZ109786163W00000X
IL041-334040163W00000X, 363LF0000X
NYF332485-1363LF0000X
AZAP1066363LF0000X
HIAPRN 881363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH102142Medicare PIN
HIH102144Medicare PIN
HIH107992Medicare PIN
HIH102143Medicare PIN
HIH102141Medicare PIN
HIP87039Medicare UPIN