Provider Demographics
NPI:1194542506
Name:HEBRIO, NYRA KEZIAH AMARO
Entity type:Individual
Prefix:
First Name:NYRA KEZIAH
Middle Name:AMARO
Last Name:HEBRIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NYRA KEZIAH
Other - Middle Name:HEBRIO
Other - Last Name:MORANTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3009 ALA MAKAHALA PL APT 715
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-7605
Mailing Address - Country:US
Mailing Address - Phone:808-226-0666
Mailing Address - Fax:
Practice Address - Street 1:820 MILILANI ST STE 400
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2934
Practice Address - Country:US
Practice Address - Phone:808-210-8209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-4755363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology