Provider Demographics
NPI:1902458961
Name:FELKINS, DIANE WENDY
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:WENDY
Last Name:FELKINS
Suffix:
Gender:F
Credentials:
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 679
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:HI
Mailing Address - Zip Code:96771-0679
Mailing Address - Country:US
Mailing Address - Phone:808-345-6720
Mailing Address - Fax:
Practice Address - Street 1:16-863 WAO KELE RD.
Practice Address - Street 2:
Practice Address - City:KURTIS TOWN
Practice Address - State:HI
Practice Address - Zip Code:96760
Practice Address - Country:US
Practice Address - Phone:808-345-6720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN60206163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool