Individual
NICOLE YAZDANPOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC,RNFA, CNOR
Contact information
Practice address
99-115 AIEA HEIGHTS DR STE 276, AIEA, HI 96701-3967
(808) 784-3050
Mailing address
91-1062 KAUNOA ST, EWA BEACH, HI 96706-3530
(808) 429-4943
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
RN-71056
HI
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN-3954
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417669532
—
HI
Enumeration date
12/20/2022
Last updated
02/06/2023
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