Healthcare Provider Details

I. General information

NPI: 1821971078
Provider Name (Legal Business Name): OHANAMED VIRTUAL URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 08/14/2025
Certification Date: 08/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 BISHOP ST STE 2700 #609
HONOLULU HI
96813-6462
US

IV. Provider business mailing address

1003 BISHOP ST STE 2700 PRIVATE MAIL BOX HON 609
HONOLULU HI
96813-6475
US

V. Phone/Fax

Practice location:
  • Phone: 808-468-5779
  • Fax:
Mailing address:
  • Phone: 808-468-5779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KYLE NEFZGER
Title or Position: OWNER/APRN HAWAII
Credential: APRN, FNP-C
Phone: 808-468-5779