Healthcare Provider Details

I. General information

NPI: 1700187523
Provider Name (Legal Business Name): GRACE GAGALA SCHONHARDT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2010
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 BISHOP ST STE 2700
HONOLULU HI
96813-6475
US

IV. Provider business mailing address

PO BOX 17485
HONOLULU HI
96817-0485
US

V. Phone/Fax

Practice location:
  • Phone: 808-664-1104
  • Fax: 866-592-3149
Mailing address:
  • Phone: 808-664-1104
  • Fax: 866-592-3149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number40589
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1398/RX377
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: