Healthcare Provider Details

I. General information

NPI: 1245630763
Provider Name (Legal Business Name): JENNIFER MAE GOARING CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2014
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1292 WAIANUENUE AVE
HILO HI
96720-1228
US

IV. Provider business mailing address

1292 WAIANUENUE AVE
HILO HI
96720-1228
US

V. Phone/Fax

Practice location:
  • Phone: 808-934-4000
  • Fax:
Mailing address:
  • Phone: 833-833-3333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN-5826
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberRN-129334
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License NumberRN00150536
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number60514138
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: