Provider Demographics
NPI:1871092106
Name:MISITANO, RACHAEL KARLA (NP)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:KARLA
Last Name:MISITANO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 BRYANT ST APT C
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-1105
Mailing Address - Country:US
Mailing Address - Phone:808-640-1982
Mailing Address - Fax:
Practice Address - Street 1:1600 KAUMANA DR
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-1407
Practice Address - Country:US
Practice Address - Phone:808-640-1982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-2329363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily