Healthcare Provider Details

I. General information

NPI: 1043462203
Provider Name (Legal Business Name): ELIZABETH DENIE HOLMES MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 10/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1741 ALA MOANA BLVD UNIT 60
HONOLULU HI
96815-1448
US

IV. Provider business mailing address

1741 ALA MOANA BLVD UNIT 60
HONOLULU HI
96815-1448
US

V. Phone/Fax

Practice location:
  • Phone: 808-927-7504
  • Fax:
Mailing address:
  • Phone: 808-927-7504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN38170
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: