Basic Information
| Provider Information | |||||||||
| NPI: | 1669401295 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ONEILL | ||||||||
| FirstName: | ADELE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | APRN | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BARKER | ||||||||
| OtherFirstName: | ADELE | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | APRN | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 165 MAA ST | ||||||||
| Address2: | |||||||||
| City: | KAHULUI | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967323603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8084467120 | ||||||||
| FaxNumber: | 8084467121 | ||||||||
| Practice Location | |||||||||
| Address1: | 165 MAA ST | ||||||||
| Address2: | |||||||||
| City: | KAHULUI | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967323603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8084467120 | ||||||||
| FaxNumber: | 8084467121 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 11/04/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | APRN864 | HI | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
ID Information
| ID | Type | State | Issuer | Description | 0258574 | 01 | HI | HMSA - 65CP - HMSA QUEST | OTHER | 57797601 | 05 | HI | MEDICAID | 112243 | 01 | HI | UHA | OTHER | 577976 | 01 | HI | ALOHA CARE QUEST | OTHER |