# WAIMEA PRIMARY CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417528399
- **Authorized official:** CARLY KALEO CORREA APRN (OWNER)
- **Authorized official phone:** (808) 756-0334

## Contact information

- **Practice address:** 65-1298B KAWAIHAE RD STE 3, KAMUELA, HI 96743-7342
- **Practice address phone:** (808) 731-5003
- **Practice address fax:** (808) 731-4330
- **Mailing address:** 65-1298B KAWAIHAE RD STE 3, KAMUELA, HI 96743-7342
- **Mailing address phone:** (808) 756-0334
- **Mailing address fax:** (808) 731-4330

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | NULL | — |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | — | — |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/01/2021
- **Last updated:** 10/12/2025