Healthcare Provider Details

I. General information

NPI: 1487931481
Provider Name (Legal Business Name): JANE KEIKO STINSON FNP-BC, RX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS JANE KEIKO ODAGAWA

II. Dates (important events)

Enumeration Date: 11/04/2011
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 PUUHONU PL STE 104
HILO HI
96720-2060
US

IV. Provider business mailing address

73 PUUHONU PL STE 104
HILO HI
96720-2060
US

V. Phone/Fax

Practice location:
  • Phone: 808-867-8002
  • Fax:
Mailing address:
  • Phone: 808-738-9354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN 513
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: