Provider Demographics
NPI:1285404996
Name:WADSWORTH, JULIA KAHALELAUKOA II H (FNP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:KAHALELAUKOA II H
Last Name:WADSWORTH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:KAHALELAUKOA II
Other - Last Name:HANNON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1881 NANI ST
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1811
Mailing Address - Country:US
Mailing Address - Phone:808-871-7772
Mailing Address - Fax:
Practice Address - Street 1:1881 NANI ST
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1811
Practice Address - Country:US
Practice Address - Phone:808-871-7772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-1709363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily