Healthcare Provider Details

I. General information

NPI: 1821827320
Provider Name (Legal Business Name): TATIANA LUKE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2024
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
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: 808-522-4360
  • Fax: 808-522-3361
Mailing address:
  • Phone: 808-522-4360
  • Fax: 808-522-3361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-4697
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: