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Organization
MIND BODY NUTRITION RN
Active
Organization
MIND BODY NUTRITION RN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH VANCE-BEAUMONT APRN (OWNER)
(415) 867-6457
Entity
Organization
Contact information
Practice address
75-5995 KUAKINI HWY STE 445, KAILUA KONA, HI 96740-2123
(808) 315-8466
Mailing address
75-5995 KUAKINI HWY STE 445, KAILUA KONA, HI 96740-2123
(808) 315-8466
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
2154
HI
Other
Enumeration date
10/18/2016
Last updated
10/18/2016
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