Provider Demographics
NPI:1881964765
Name:RAO, MALIA RIBEIRO (APRN-RX, FNP-C)
Entity type:Individual
Prefix:DR
First Name:MALIA
Middle Name:RIBEIRO
Last Name:RAO
Suffix:
Gender:F
Credentials:APRN-RX, FNP-C
Other - Prefix:
Other - First Name:MALIA
Other - Middle Name:
Other - Last Name:RIBEIRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP, APRN-RX
Mailing Address - Street 1:91-2141 FORT WEAVER RD
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-1993
Mailing Address - Country:US
Mailing Address - Phone:808-691-3165
Mailing Address - Fax:
Practice Address - Street 1:377 KEAHOLE ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-3405
Practice Address - Country:US
Practice Address - Phone:808-395-4427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI65348163W00000X
HIAPRN-1431363LF0000X
HI1431363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI737588Medicaid