Healthcare Provider Details

I. General information

NPI: 1376911156
Provider Name (Legal Business Name): ROBIN PACSON APRN, MSN, GNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2015
Last Update Date: 09/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 S KING ST
HONOLULU HI
96813-3097
US

IV. Provider business mailing address

888 S KING ST
HONOLULU HI
96813-3097
US

V. Phone/Fax

Practice location:
  • Phone: 808-522-4000
  • Fax:
Mailing address:
  • Phone: 808-522-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN - 46763
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN - 1032
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: