Healthcare Provider Details

I. General information

NPI: 1275363970
Provider Name (Legal Business Name): BOWKEO SNIFFEN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2024
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 ALA MOANA BLVD
HONOLULU HI
96813-4920
US

IV. Provider business mailing address

2560 BOOTH RD
HONOLULU HI
96813-1146
US

V. Phone/Fax

Practice location:
  • Phone: 407-306-8441
  • Fax: 407-306-8662
Mailing address:
  • Phone: 720-474-4590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-4603
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: