Healthcare Provider Details

I. General information

NPI: 1952965113
Provider Name (Legal Business Name): NANCY STRICKLEN-JUNEAU APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2019
Last Update Date: 04/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 WAIANUENUE AVE
HILO HI
96720-2089
US

IV. Provider business mailing address

724B WAINAKU ST
HILO HI
96720-2182
US

V. Phone/Fax

Practice location:
  • Phone: 808-932-3000
  • Fax:
Mailing address:
  • Phone: 775-450-2526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2649
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: