Provider Demographics
NPI:1689419707
Name:MADELA, JONAMAE
Entity type:Individual
Prefix:
First Name:JONAMAE
Middle Name:
Last Name:MADELA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-321 HILIHUA WAY
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3611
Mailing Address - Country:US
Mailing Address - Phone:808-436-5926
Mailing Address - Fax:
Practice Address - Street 1:94-321 HILIHUA WAY
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3611
Practice Address - Country:US
Practice Address - Phone:808-436-5926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-29
Last Update Date:2024-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIGE-043-785-4720-01374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide