Provider Demographics
NPI:1740313220
Name:CARINIO, MICHELLE RENE (LPN)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:RENE
Last Name:CARINIO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2352 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-3638
Mailing Address - Country:US
Mailing Address - Phone:808-433-0236
Mailing Address - Fax:808-433-0310
Practice Address - Street 1:459 PATTERSON RD
Practice Address - Street 2:BLDG. #110
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-1522
Practice Address - Country:US
Practice Address - Phone:808-433-0236
Practice Address - Fax:808-433-0310
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN183722164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse