Healthcare Provider Details

I. General information

NPI: 1487326963
Provider Name (Legal Business Name): KYLE DRAPER LUMSDEN DNP, FNP-BC, APRN-RX
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 10/01/2021
Certification Date: 10/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 LILIHA ST STE 104
HONOLULU HI
96817-7357
US

IV. Provider business mailing address

92-1048 KANEHOA LOOP APT 73
KAPOLEI HI
96707-1301
US

V. Phone/Fax

Practice location:
  • Phone: 808-261-4476
  • Fax: 808-263-4476
Mailing address:
  • Phone: 540-556-9722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-3338-0
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: