Healthcare Provider Details

I. General information

NPI: 1205303716
Provider Name (Legal Business Name): BRENDA LEE ORCUTT DNP, APRN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2018
Last Update Date: 11/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 ULULANI ST
HILO HI
96720-2933
US

IV. Provider business mailing address

PO BOX 6940
HILO HI
96720-8936
US

V. Phone/Fax

Practice location:
  • Phone: 808-934-9675
  • Fax:
Mailing address:
  • Phone: 808-557-7284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-2558
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: