Healthcare Provider Details

I. General information

NPI: 1083846273
Provider Name (Legal Business Name): JOSETTE DUDOIT APRN-RX, R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2009
Last Update Date: 02/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 LUSITANA ST SUITE 814
HONOLULU HI
96813-2449
US

IV. Provider business mailing address

1380 LUSITANA ST SUITE 814
HONOLULU HI
96813-2449
US

V. Phone/Fax

Practice location:
  • Phone: 808-521-3802
  • Fax: 808-521-1738
Mailing address:
  • Phone: 808-521-3802
  • Fax: 808-521-1738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number991188
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-1881
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: