Provider Demographics
NPI:1285376905
Name:CARDON, MARIKIT G (CNA)
Entity type:Individual
Prefix:
First Name:MARIKIT
Middle Name:G
Last Name:CARDON
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 1:548 S KAMEHAMEHA AVE
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-1939
Mailing Address - Country:US
Mailing Address - Phone:808-453-0931
Mailing Address - Fax:808-214-6845
Practice Address - Street 1:849 HOOMAU ST
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-9424
Practice Address - Country:US
Practice Address - Phone:808-453-0931
Practice Address - Fax:808-419-6637
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-12
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1-190009311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home