Healthcare Provider Details

I. General information

NPI: 1780896704
Provider Name (Legal Business Name): CHRISTINA COLLINS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 11/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75-5759 KUAKINI HWY SUITE 202
KAILUA KONA HI
96740-1726
US

IV. Provider business mailing address

75-5759 KUAKINI HWY SUITE 202
KAILUA KONA HI
96740-1726
US

V. Phone/Fax

Practice location:
  • Phone: 808-331-2300
  • Fax:
Mailing address:
  • Phone: 808-331-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMD13205
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberMD13205
License Number StateHI

VIII. Authorized Official

Name: DR. CHRISTINA COLLINS
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 808-331-2300