Individual
SHO PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
599 FARRINGTON HWY STE 201, KAPOLEI, HI 96707-2028
(808) 691-7338
Mailing address
599 FARRINGTON HWY STE 201, KAPOLEI, HI 96707-2028
(808) 691-7338
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
22 714607
NY
363LF0000X
Family Nurse Practitioner
26NJ00812200
NJ
363LF0000X
Family Nurse Practitioner
95013080
CA
363LF0000X
Family Nurse Practitioner
Primary
APRN-3493
HI
Other
Enumeration date
02/17/2017
Last updated
06/21/2022
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