Healthcare Provider Details

I. General information

NPI: 1548124928
Provider Name (Legal Business Name): HEATHER KENT APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82-5938 GOVERNMENT MAIN RD
CAPTAIN COOK HI
96704-8368
US

IV. Provider business mailing address

82-5938 GOVERNMENT MAIN RD
CAPTAIN COOK HI
96704-8368
US

V. Phone/Fax

Practice location:
  • Phone: 808-989-3856
  • Fax:
Mailing address:
  • Phone: 808-989-3856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-5629
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: