Healthcare Provider Details

I. General information

NPI: 1467511881
Provider Name (Legal Business Name): LEE AUSTIN CRNA, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 10/19/2024
Certification Date: 10/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 W HIND DR STE 114
HONOLULU HI
96821-1845
US

IV. Provider business mailing address

850 W HIND DR STE 114
HONOLULU HI
96821-1845
US

V. Phone/Fax

Practice location:
  • Phone: 808-784-0007
  • Fax: 808-501-0886
Mailing address:
  • Phone: 808-784-0007
  • Fax: 808-501-0886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-79220
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN592567
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberNA2796
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN-1981
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: