Healthcare Provider Details

I. General information

NPI: 1457408049
Provider Name (Legal Business Name): PAULETTE L NAKAMURA CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 PAA ST
HONOLULU HI
96819-4405
US

IV. Provider business mailing address

2828 PAA ST
HONOLULU HI
96819-4405
US

V. Phone/Fax

Practice location:
  • Phone: 808-432-5770
  • Fax:
Mailing address:
  • Phone: 808-432-5770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberAPRN-666
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: