Healthcare Provider Details

I. General information

NPI: 1114736386
Provider Name (Legal Business Name): SUZANNA KIKI LIEU APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2025
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N KUAKINI ST STE 404
HONOLULU HI
96817-2360
US

IV. Provider business mailing address

321 N KUAKINI ST STE 412
HONOLULU HI
96817-2360
US

V. Phone/Fax

Practice location:
  • Phone: 808-686-4244
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-4694-0
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: