Healthcare Provider Details

I. General information

NPI: 1699906222
Provider Name (Legal Business Name): SONDRA LEE LEIGGI BRANDON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2009
Last Update Date: 11/23/2020
Certification Date: 11/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 WAIMANU ST STE 600
HONOLULU HI
96813-5267
US

IV. Provider business mailing address

PO BOX 893663
MILILANI HI
96789-0663
US

V. Phone/Fax

Practice location:
  • Phone: 808-533-3936
  • Fax: 808-791-6198
Mailing address:
  • Phone: 808-691-3610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN 1408
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1408
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: