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Individual

MICHAEL NISHIMOTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PNP

Contact information

Practice address
1310 PUNAHOU ST, HONOLULU, HI 96826-1027
(808) 941-4466
(808) 951-3718
Mailing address
PO BOX 8500, LOCKBOX 7642, PHILADELPHIA, PA 19178-7642
(813) 281-8115
(813) 281-8656

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1684
HI
363LP0200X
Pediatric Nurse Practitioner
NP21018
CA

Other

Enumeration date
01/19/2012
Last updated
01/27/2016
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