Healthcare Provider Details

I. General information

NPI: 1134002488
Provider Name (Legal Business Name): AMY OLSEN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date: 08/21/2025
Reactivation Date: 04/13/2026

III. Provider practice location address

444 HOBRON LN STE PH1
HONOLULU HI
96815-1231
US

IV. Provider business mailing address

PO BOX 384235
WAIKOLOA HI
96738-4235
US

V. Phone/Fax

Practice location:
  • Phone: 808-272-8610
  • Fax:
Mailing address:
  • Phone: 808-272-8610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number6105
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: