Healthcare Provider Details

I. General information

NPI: 1831595115
Provider Name (Legal Business Name): BRANDY KIRSTEIN DNP, FNP-C, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2014
Last Update Date: 03/10/2021
Certification Date: 03/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST
HONOLULU HI
96826-1001
US

IV. Provider business mailing address

1319 PUNAHOU ST
HONOLULU HI
96826-1001
US

V. Phone/Fax

Practice location:
  • Phone: 808-600-8790
  • Fax:
Mailing address:
  • Phone: 808-600-8790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-59180
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3120
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: