Provider Demographics
NPI:1831841006
Name:AQUINO, PAULA NICHAELLE EXCONDE (MSN, APRN-RX, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:PAULA NICHAELLE
Middle Name:EXCONDE
Last Name:AQUINO
Suffix:
Gender:F
Credentials:MSN, APRN-RX, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-1200 KEAUNUI DR APT 1
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-4698
Mailing Address - Country:US
Mailing Address - Phone:808-724-8156
Mailing Address - Fax:
Practice Address - Street 1:94-837 WAIPAHU ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3320
Practice Address - Country:US
Practice Address - Phone:808-671-3911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-19
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN-95446163W00000X
HIAPRN-3591363LF0000X, 363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI002763Medicaid