Provider Demographics
NPI:1740722594
Name:MAGNAYON PRADO, MELINDA RAGAS (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:RAGAS
Last Name:MAGNAYON PRADO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:RAGAS
Other - Last Name:ANDREASSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:92-7151 ELELE ST APT 1405
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-3389
Mailing Address - Country:US
Mailing Address - Phone:808-724-0278
Mailing Address - Fax:844-814-8049
Practice Address - Street 1:92-7151 ELELE ST APT 1405
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-3389
Practice Address - Country:US
Practice Address - Phone:808-724-0278
Practice Address - Fax:844-814-8049
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-10
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI69772163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
1740722594OtherNPI