Provider Demographics
NPI:1396916144
Name:VERTIDO, MAY JOYCE ALOG (RN)
Entity type:Individual
Prefix:
First Name:MAY JOYCE
Middle Name:ALOG
Last Name:VERTIDO
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 1:94-1043 AWANANI ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3249
Mailing Address - Country:US
Mailing Address - Phone:808-677-7620
Mailing Address - Fax:
Practice Address - Street 1:CMR 416 BOX C
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09140
Practice Address - Country:DE
Practice Address - Phone:49984-183-5136
Practice Address - Fax:49984-183-4834
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI52850163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN