| Doctor Name: | MRS. JODY ANN MAIN |
| NPI Number: | 1235360801 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 39439 |
| Business Practice Address: | 91-2301 Old Ft Weaver Rd Ewa Beach, HI - 967063602 |
| Business Phone Number: | 8086772525 |
| Business Fax Number: | 8086772570 |
| Mailing Address: | 91-1175 Kuanoo St, EWA BEACH |
| State: | HI |
| Postal Code: | 967064634 |
| Phone Number: | 8082201942 |
| Fax Number: | |
| NPI Enumeration Date: | 07/30/2009 |
| NPI Last Update Date: | 07/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 39439 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | HI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |