Healthcare Provider Details

I. General information

NPI: 1548181126
Provider Name (Legal Business Name): BROOKE MICHI PROTACIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

459 PATTERSON RD
HONOLULU HI
96819-1522
US

IV. Provider business mailing address

828 AUAHI ST UNIT 2307
HONOLULU HI
96813-5380
US

V. Phone/Fax

Practice location:
  • Phone: 808-829-9909
  • Fax:
Mailing address:
  • Phone: 808-291-4510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-6001
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: