Healthcare Provider Details

I. General information

NPI: 1851083257
Provider Name (Legal Business Name): AMBER IMAN WARD LM, CPM, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2023
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5425 KILMER LN
HONOLULU HI
96818-3921
US

IV. Provider business mailing address

5425 KILMER LN
HONOLULU HI
96818-3467
US

V. Phone/Fax

Practice location:
  • Phone: 808-219-3596
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW-41-0
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-316889
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: