Healthcare Provider Details

I. General information

NPI: 1750929253
Provider Name (Legal Business Name): CHERYL ANN AFUSO-SUMIMOTO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2019
Last Update Date: 12/20/2019
Certification Date: 12/20/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PUNCHBOWL ST
HONOLULU HI
96813-2499
US

IV. Provider business mailing address

1301 PUNCHBOWL ST
HONOLULU HI
96813-2499
US

V. Phone/Fax

Practice location:
  • Phone: 808-691-8777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SX0200X
TaxonomyOncology Clinical Nurse Specialist
License NumberAPRN-2790
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: