Healthcare Provider Details

I. General information

NPI: 1396093472
Provider Name (Legal Business Name): JOSEPH GIOVANNONI APRN RX
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2012
Last Update Date: 08/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 S KING ST SUITE 953
HONOLULU HI
96814-1956
US

IV. Provider business mailing address

1314 S KING ST SUITE 953
HONOLULU HI
96814-1956
US

V. Phone/Fax

Practice location:
  • Phone: 808-596-2463
  • Fax:
Mailing address:
  • Phone: 808-596-2463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number446
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: