Provider Demographics
NPI:1902460686
Name:JAUSSI, REBECCA (ARNP, APRN, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:JAUSSI
Suffix:
Gender:F
Credentials:ARNP, APRN, FNP-C
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 975
Mailing Address - Street 2:
Mailing Address - City:LAIE
Mailing Address - State:HI
Mailing Address - Zip Code:96762-0975
Mailing Address - Country:US
Mailing Address - Phone:801-949-7758
Mailing Address - Fax:
Practice Address - Street 1:56-117 PUALALEA ST
Practice Address - Street 2:
Practice Address - City:KAHUKU
Practice Address - State:HI
Practice Address - Zip Code:96731-2052
Practice Address - Country:US
Practice Address - Phone:808-293-6239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-27
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61089180163W00000X
HI85367163W00000X
WAAP61089597363LF0000X
HIAPRN3086363LP2300X
HIAPRN-3086363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty