Provider Demographics
NPI:1689480907
Name:GALAVIZ, JOLENE ALEXANDRA (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:JOLENE
Middle Name:ALEXANDRA
Last Name:GALAVIZ
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2596 WAIANAE UKA AVE
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-7022
Mailing Address - Country:US
Mailing Address - Phone:806-787-5394
Mailing Address - Fax:
Practice Address - Street 1:935 CALIFORNIA AVE STE B17
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-2166
Practice Address - Country:US
Practice Address - Phone:808-778-5824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-10
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-4943-0363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily