Healthcare Provider Details

I. General information

NPI: 1891947669
Provider Name (Legal Business Name): MACEY MIN-CHU LUO-SOUZA APRN-RX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MACEY MIN-CHU LUO RN, APRN

II. Dates (important events)

Enumeration Date: 10/10/2008
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

928 NUUANU AVE LOWR LEVEL
HONOLULU HI
96817-5193
US

IV. Provider business mailing address

928 NUUANU AVE LOWR LEVEL
HONOLULU HI
96817-5193
US

V. Phone/Fax

Practice location:
  • Phone: 808-383-2644
  • Fax: 808-536-2024
Mailing address:
  • Phone: 808-628-8435
  • Fax: 808-536-2024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License NumberAPRN-1509
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-59164
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: