Healthcare Provider Details

I. General information

NPI: 1184923153
Provider Name (Legal Business Name): MONIKA N TOMITA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2011
Last Update Date: 03/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PUNCHBOWL ST
HONOLULU HI
96813-2402
US

IV. Provider business mailing address

PO BOX 29640
HONOLULU HI
96820-2040
US

V. Phone/Fax

Practice location:
  • Phone: 808-585-5494
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberAPRN1099
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN45007
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: