Healthcare Provider Details

I. General information

NPI: 1275863870
Provider Name (Legal Business Name): KAREN LOUISE DAVIS MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN LOUISE MOYER

II. Dates (important events)

Enumeration Date: 01/04/2010
Last Update Date: 04/15/2024
Certification Date: 04/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 PONAHAWAI ST STE 202
HILO HI
96720-3074
US

IV. Provider business mailing address

1520 LILIHA ST STE 601
HONOLULU HI
96817-3564
US

V. Phone/Fax

Practice location:
  • Phone: 808-523-0445
  • Fax: 808-356-3380
Mailing address:
  • Phone: 808-523-0445
  • Fax: 808-356-3380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-4417-0
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN-116716-0
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: