Provider Demographics
NPI:1861789760
Name:NINO, NANCY (LMT)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:NINO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 WAIALAE AVE
Mailing Address - Street 2:STE 330
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5842
Mailing Address - Country:US
Mailing Address - Phone:808-347-4747
Mailing Address - Fax:
Practice Address - Street 1:3221 WAIALAE AVE
Practice Address - Street 2:STE 330
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5842
Practice Address - Country:US
Practice Address - Phone:808-347-4747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI10975225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist