Provider Demographics
NPI:1700673449
Name:ICARANGAL, HEIDI C (RN)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:C
Last Name:ICARANGAL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1001 DILLINGHAM BLVD STE 317
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-4551
Mailing Address - Country:US
Mailing Address - Phone:808-221-8425
Mailing Address - Fax:808-809-8585
Practice Address - Street 1:1001 DILLINGHAM BLVD STE 317
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-4551
Practice Address - Country:US
Practice Address - Phone:808-294-7465
Practice Address - Fax:808-809-8585
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN-58396163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health