Healthcare Provider Details

I. General information

NPI: 1154070415
Provider Name (Legal Business Name): HYE JOO MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2022
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 S KING ST
HONOLULU HI
96813-3097
US

IV. Provider business mailing address

888 S KING ST
HONOLULU HI
96813-3097
US

V. Phone/Fax

Practice location:
  • Phone: 808-522-4321
  • Fax: 808-522-3024
Mailing address:
  • Phone: 808-522-4321
  • Fax: 808-522-3024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-3571-0
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: