Healthcare Provider Details

I. General information

NPI: 1912765256
Provider Name (Legal Business Name): EMILEE NICHOLE MOYER CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 IWILEI RD STE 660
HONOLULU HI
96817-5392
US

IV. Provider business mailing address

680 IWILEI RD STE 660
HONOLULU HI
96817-5392
US

V. Phone/Fax

Practice location:
  • Phone: 808-924-9255
  • Fax: 808-922-9161
Mailing address:
  • Phone: 808-924-9255
  • Fax: 808-924-9255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN-5141
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: