Provider Demographics
NPI:1760343651
Name:FABIA, CORTEZ RAFEL (FNP)
Entity type:Individual
Prefix:MR
First Name:CORTEZ
Middle Name:RAFEL
Last Name:FABIA
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 YOUNG ST APT 402
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1930
Mailing Address - Country:US
Mailing Address - Phone:817-915-7628
Mailing Address - Fax:
Practice Address - Street 1:1125 YOUNG ST APT 402
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1930
Practice Address - Country:US
Practice Address - Phone:817-915-7628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-20
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-5583363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily