Provider Demographics
NPI:1871157966
Name:AQUE, LOUISSE GAYLE FUNIESTAS (BSN, RN)
Entity type:Individual
Prefix:
First Name:LOUISSE GAYLE
Middle Name:FUNIESTAS
Last Name:AQUE
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-1036 HOOHELE ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-4762
Mailing Address - Country:US
Mailing Address - Phone:808-391-9232
Mailing Address - Fax:
Practice Address - Street 1:45-386 KANEOHE BAY DR
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-2248
Practice Address - Country:US
Practice Address - Phone:808-391-9232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI84138163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse