Provider Demographics
NPI:1841896024
Name:ACHACOSO, JOHN PAUL ANTHONY (RN)
Entity type:Individual
Prefix:
First Name:JOHN PAUL
Middle Name:ANTHONY
Last Name:ACHACOSO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92-1545 ALIINUI DR UNIT 3D
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2226
Mailing Address - Country:US
Mailing Address - Phone:510-449-8028
Mailing Address - Fax:
Practice Address - Street 1:6905 HARRIS AVE, MCBH
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96734-9673
Practice Address - Country:US
Practice Address - Phone:808-473-1880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI99325163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse