Provider Demographics
NPI:1962624973
Name:RABIDEAU, JENNIFER MARIE (RN BSN CDE)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:MARIE
Last Name:RABIDEAU
Suffix:
Gender:F
Credentials:RN BSN CDE
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 6498
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-6498
Mailing Address - Country:US
Mailing Address - Phone:808-881-4496
Mailing Address - Fax:808-885-1042
Practice Address - Street 1:67-1125 MAMALAHOA HWY
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8496
Practice Address - Country:US
Practice Address - Phone:808-881-4496
Practice Address - Fax:808-885-1042
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN46841163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000250894OtherHMSA