ALLYSA CHANTEL BAXLEY
Individual Provider (NPI-1)
Active
Licensed Practical Nurse
Provider Information
- NPI Number
1285273581- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 2134 KOLEKOLE AVE, WAHIAWA, HI, 967867028
- Phone
- (931) 241-0497
Specialties & Taxonomies
Licensed Practical Nurse
Primary License: HI #19774
All Addresses
MAILING
2134 KOLEKOLE AVE
WAHIAWA, HI, 967867028