Organization
PRIMARY CARE COLLECTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEAGAN GUISE (AUTHORIZED OFFICIAL)
(803) 381-2212
Entity
Organization
Contact information
Practice address
1353 KULOAA PL, KAILUA, HI 96734-3655
(803) 381-2212
Mailing address
1353 KULOAA PL, KAILUA, HI 96734-3655
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/07/2025
Last updated
01/14/2026
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