Healthcare Provider Details

I. General information

NPI: 1578307203
Provider Name (Legal Business Name): MA GENNYLOU HAUF MSN, APRN-RX, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2024
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 ALA MOANA BLVD
HONOLULU HI
96813-4920
US

IV. Provider business mailing address

500 ALA MOANA BLVD
HONOLULU HI
96813-4920
US

V. Phone/Fax

Practice location:
  • Phone: 407-306-8441
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2024027854
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: