Healthcare Provider Details

I. General information

NPI: 1841825973
Provider Name (Legal Business Name): JUSTIN ATKINS DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2020
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4211 WAIALAE AVE STE 208
HONOLULU HI
96816-5312
US

IV. Provider business mailing address

4348 WAIALAE AVE # 742
HONOLULU HI
96816-5767
US

V. Phone/Fax

Practice location:
  • Phone: 808-888-5228
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-95366
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-5266-0
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: