Healthcare Provider Details

I. General information

NPI: 1003120734
Provider Name (Legal Business Name): CLAIRE PIECHOTA SANTOS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2010
Last Update Date: 08/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 PROSPECT ST 504
HONOLULU HI
96813-1936
US

IV. Provider business mailing address

670 PROSPECT STREET 504
HONOLULU HI
96813-1929
US

V. Phone/Fax

Practice location:
  • Phone: 808-521-4470
  • Fax: 808-521-5499
Mailing address:
  • Phone: 808-521-4470
  • Fax: 808-521-5499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN 24910
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: