Provider Demographics
NPI:1770750127
Name:FUIMAONO-POE, ME LAVONNE (APRN RX- NP C)
Entity type:Individual
Prefix:
First Name:ME
Middle Name:LAVONNE
Last Name:FUIMAONO-POE
Suffix:
Gender:F
Credentials:APRN RX- NP C
Other - Prefix:MRS
Other - First Name:MAE
Other - Middle Name:LAVONNE
Other - Last Name:FUIMAONO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-RX
Mailing Address - Street 1:1132 BISHOP ST UNIT 1704
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2893
Mailing Address - Country:US
Mailing Address - Phone:808-489-2925
Mailing Address - Fax:
Practice Address - Street 1:677 ALA MOANA BLVD STE 903
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5416
Practice Address - Country:US
Practice Address - Phone:808-308-0300
Practice Address - Fax:833-471-5801
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN 1753363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI539372-18Medicaid