Individual
SUSAN HARTMAN-FUKUMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4440 MAKOI PL, LIHUE, HI 96766-9008
(808) 635-2820
Mailing address
4440 MAKOI PL, LIHUE, HI 96766-9008
(808) 635-2820
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN29907
HI
163WC0200X
Critical Care Medicine Registered Nurse
RN29907
HI
Other
Enumeration date
05/15/2019
Last updated
05/15/2019
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