Individual
MICA CRISP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1301 PUNCHBOWL ST, HONOLULU, HI 96813-2402
(808) 691-1000
Mailing address
1200 QUEEN EMMA ST APT 1602, HONOLULU, HI 96813-6308
(206) 818-9239
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP60774418
WA
363LF0000X
Family Nurse Practitioner
Primary
APRN-2694
HI
Other
Enumeration date
07/20/2017
Last updated
11/27/2023
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