Healthcare Provider Details

I. General information

NPI: 1457977548
Provider Name (Legal Business Name): VICTORIA MONIQUE YAO FNP-C, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 06/24/2020
Certification Date: 06/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-1079 MOANALUA RD STE 500
AIEA HI
96701-4794
US

IV. Provider business mailing address

47-285 HUI IWA ST APT B
KANEOHE HI
96744-4392
US

V. Phone/Fax

Practice location:
  • Phone: 808-488-0990
  • Fax:
Mailing address:
  • Phone: 808-372-2557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-2952
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: