De La Garza, Jacqueline Lynette

De La Garza, Jacqueline Lynette is an individual health care provider with primary practice located at 67-1123 Mamalahoa Hwy Ste 120124 , Kamuela HI 96743-8451. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. De La Garza, Jacqueline Lynette can be contacted via phone (808) 881-4710.

Contact Information

Primary practice address
67-1123 Mamalahoa Hwy Ste 120124 Kamuela HI 96743-8451
Phone: (808) 881-4710
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN-106817 Hawaii
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN-3777 Hawaii

Profile Details

NPI number 1063111391
LBN Legal business name De La Garza, Jacqueline Lynette
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2023
Last updated Jul 2nd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063111391 NPPES
Hawaii Other RN-106817 HI RN LICENSURE
Hawaii Other APRN-3777 HI RN LICENSURE

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