| Vanessa H. Eaglin, Md Llc | |
|
180 Kinoole St Ste 202 Hilo HI 96720-2827 | |
| (808) 470-6754 | |
| (808) 333-5120 |
| Full Name | Vanessa H. Eaglin, Md Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 180 Kinoole St Ste 202, Hilo, Hawaii |
| Authorized Official Name and Position | Vanessa Hulali Eaglin (OWNER) |
| Authorized Official Contact | 8085576261 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vanessa H. Eaglin, Md Llc 180 Kinoole St Ste 202 Hilo HI 96720-2827 Ph: (808) 470-6754 | Vanessa H. Eaglin, Md Llc 180 Kinoole St Ste 202 Hilo HI 96720-2827 Ph: (808) 470-6754 |
| NPI Number | 1982472338 |
|---|---|
| Provider Enumeration Date | 12/14/2023 |
| Last Update Date | 12/14/2023 |
| Certification Date | 12/14/2023 |
| Medicare PECOS PAC ID | 4486007838 |
|---|---|
| Medicare Enrollment ID | O20240201001271 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982472338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Vanessa Hulali Eaglin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194931196 PECOS PAC ID: 5395198741 Enrollment ID: I20240201001396 |
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