Provider Demographics
NPI:1750919825
Name:YAMAGATA-LOPEZ, JANEA (RN, DNP)
Entity type:Individual
Prefix:
First Name:JANEA
Middle Name:
Last Name:YAMAGATA-LOPEZ
Suffix:
Gender:F
Credentials:RN, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1195 IKENA CIR
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-2559
Mailing Address - Country:US
Mailing Address - Phone:808-870-0284
Mailing Address - Fax:
Practice Address - Street 1:1001 KAMOKILA BLVD
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2014
Practice Address - Country:US
Practice Address - Phone:808-220-5832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN2870363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology