Healthcare Provider Details

I. General information

NPI: 1639238652
Provider Name (Legal Business Name): MOLLY K ROTHMEYER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 01/22/2023
Certification Date: 06/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1887 MAKUAKANE ST
HONOLULU HI
96817-1887
US

IV. Provider business mailing address

299 REASONER RD
HONOLULU HI
96819-1517
US

V. Phone/Fax

Practice location:
  • Phone: 808-842-8211
  • Fax:
Mailing address:
  • Phone: 253-683-9754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30007292
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-3836
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNURU1458
License Number StateAK
# 4
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License NumberAPRN-3836
License Number StateHI
# 5
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License NumberNURU1458
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: