Provider Demographics
NPI:1063983450
Name:JULIANO, MADELYN (CNA)
Entity type:Individual
Prefix:
First Name:MADELYN
Middle Name:
Last Name:JULIANO
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 KANANI ST
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1685
Mailing Address - Country:US
Mailing Address - Phone:808-652-7271
Mailing Address - Fax:808-632-0752
Practice Address - Street 1:2911 KANANI ST
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1685
Practice Address - Country:US
Practice Address - Phone:808-652-7271
Practice Address - Fax:808-632-0752
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency