Provider Demographics
NPI:1356159701
Name:PAHUKOA-MALIA, RACHEL DIANE (APRN)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:DIANE
Last Name:PAHUKOA-MALIA
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 1:2214 AUHUHU ST
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-1228
Mailing Address - Country:US
Mailing Address - Phone:915-355-2197
Mailing Address - Fax:
Practice Address - Street 1:935 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-2165
Practice Address - Country:US
Practice Address - Phone:808-778-5824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-4964363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily