Provider Demographics
NPI:1487066239
Name:HALE, CHERILYN
Entity type:Individual
Prefix:
First Name:CHERILYN
Middle Name:
Last Name:HALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45-773 KAMEHAMEHA HWY
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2971
Mailing Address - Country:US
Mailing Address - Phone:808-235-6405
Mailing Address - Fax:808-235-1754
Practice Address - Street 1:45-773 KAMEHAMEHA HWY
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-2971
Practice Address - Country:US
Practice Address - Phone:808-235-6405
Practice Address - Fax:808-235-1754
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIVE-560174M00000X
CA18000174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian