Healthcare Provider Details
I. General information
NPI: 1902740020
Provider Name (Legal Business Name): SHAUNISTY SILVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
459 PATTERSON RD
HONOLULU HI
96819-1522
US
IV. Provider business mailing address
91-1213 KANEANA ST APT C
EWA BEACH HI
96706-3788
US
V. Phone/Fax
- Phone: 808-433-0600
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 122427 |
| License Number State | HI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: