Healthcare Provider Details

I. General information

NPI: 1902358641
Provider Name (Legal Business Name): HOLLIE RENEE SEWARD APRN-RX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2016
Last Update Date: 09/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54-316 KAMEHAMEHA HWY STE 6
HAUULA HI
96717
US

IV. Provider business mailing address

PO BOX 395
KAHUKU HI
96731-0395
US

V. Phone/Fax

Practice location:
  • Phone: 808-293-9216
  • Fax: 808-293-1511
Mailing address:
  • Phone: 808-293-9216
  • Fax: 808-293-1511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5009056
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberM7L1Q7
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN2439
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: