Provider Demographics
NPI:1124826029
Name:SOLAITA, AGALELEIIASOUMA TU'UPULE (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:AGALELEIIASOUMA
Middle Name:TU'UPULE
Last Name:SOLAITA
Suffix:
Gender:
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1005
Mailing Address - Street 2:
Mailing Address - City:PAGO PAGO
Mailing Address - State:AS
Mailing Address - Zip Code:96799-1005
Mailing Address - Country:US
Mailing Address - Phone:684-699-3730
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1005
Practice Address - Street 2:
Practice Address - City:PAGO PAGO
Practice Address - State:AS
Practice Address - Zip Code:96799-1005
Practice Address - Country:US
Practice Address - Phone:684-699-3730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ASRN-1048-A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse