Provider Demographics
NPI:1245012442
Name:MAGLIDT, DENISE ROBERTA (APRN-RX)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:ROBERTA
Last Name:MAGLIDT
Suffix:
Gender:F
Credentials:APRN-RX
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 HALEKOA DR
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-1125
Mailing Address - Country:US
Mailing Address - Phone:808-421-8483
Mailing Address - Fax:
Practice Address - Street 1:3-3420 KUHIO HWY
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1042
Practice Address - Country:US
Practice Address - Phone:808-245-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-20
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-4293-0363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily