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Organization
BANYAN WELLNESS CENTER LLC
Active
Organization
BANYAN WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAYNA NICOLE MILLER PMHNP-BC (OWNER)
(808) 633-7132
Entity
Organization
Contact information
Practice address
320 OHUKAI RD STE 414, KIHEI, HI 96753-7060
(808) 666-1937
Mailing address
320 OHUKAI RD STE 414, KIHEI, HI 96753-7060
(808) 666-1937
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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