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NPI Profile for JACKIELYN BAUTISTA in EWA BEACH, HI.
An individual, often licensed by the state, who is responsible for the management of a nursing home.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Nursing Home Administrator |
376G00000X |
| NPI # | 1265988513 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 08/28/2016 | |
| Last updated | 08/28/2016 - About 10 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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JACKIELYN BAUTISTA
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JACKIELYN BAUTISTA