MEDICARE: LEE AUSTIN CRNA, APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN-79220	HI
2	163W00000X	Registered Nurse	RN592567	CA
3	367500000X	Certified Registered Nurse Anesthetist	NA2796	CA
4	367500000X	Certified Registered Nurse Anesthetist	APRN-1981	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NA0027960	OTHER	CA	BLUE SHIELD OF CA
2	359252000	OTHER	CA	US DEPT OF LABOR
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467511881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEE AUSTIN CRNA, APRN

Provider Business Mailing Address
First Line	:	850 W HIND DR STE 114
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96821-1845
Country	:	US
Telephone Number	:	808-784-0007
Fax Number	:	808-501-0886

Provider Business Practice Location Address
First Line	:	850 W HIND DR STE 114
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96821-1845
Country	:	US
Telephone Number	:	808-784-0007
Fax Number	:	808-501-0886

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	10/19/2024

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Directions to “ LEE AUSTIN CRNA, APRN” Practice Location

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