Healthcare Provider Details

I. General information

NPI: 1225967631
Provider Name (Legal Business Name): GLOW HEALTH AND WELLNESS CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3751 HANAPEPE RD. UNIT 2
HANAPEPE HI
96716
US

IV. Provider business mailing address

PO BOX 983
KOLOA HI
96756-0983
US

V. Phone/Fax

Practice location:
  • Phone: 808-631-2766
  • Fax:
Mailing address:
  • Phone: 808-631-2766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CELESTE INDVIK BROWN
Title or Position: OWNER
Credential: NP
Phone: 808-499-5941