Provider Demographics
NPI:1104684596
Name:FUJIE-FUKUKI, ASHLEY-RAE NOBUKO VALLEDOR (APRN)
Entity type:Individual
Prefix:
First Name:ASHLEY-RAE
Middle Name:NOBUKO VALLEDOR
Last Name:FUJIE-FUKUKI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 ALENA PL
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-5741
Mailing Address - Country:US
Mailing Address - Phone:808-854-6770
Mailing Address - Fax:
Practice Address - Street 1:3382 WAIALAE AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-2637
Practice Address - Country:US
Practice Address - Phone:088-548-7033
Practice Address - Fax:808-548-7034
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-4501363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner