Provider Demographics
NPI:1922826320
Name:MANAYAN, VIAN JAYLIE G
Entity type:Individual
Prefix:
First Name:VIAN JAYLIE
Middle Name:G
Last Name:MANAYAN
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 1:94-1018 LUMIALANI ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3917
Mailing Address - Country:US
Mailing Address - Phone:808-376-8624
Mailing Address - Fax:808-376-8624
Practice Address - Street 1:94-1018 LUMIALANI ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3917
Practice Address - Country:US
Practice Address - Phone:808-376-8624
Practice Address - Fax:808-376-8624
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN-82529163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty