Healthcare Provider Details

I. General information

NPI: 1568530681
Provider Name (Legal Business Name): WINDWARD WOMEN'S CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 AULIKE ST STE 211
KAILUA HI
96734-2753
US

IV. Provider business mailing address

40 AULIKE ST STE 211
KAILUA HI
96734-2753
US

V. Phone/Fax

Practice location:
  • Phone: 808-263-7383
  • Fax: 808-263-0050
Mailing address:
  • Phone: 808-263-7383
  • Fax: 808-263-0050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateHI

VIII. Authorized Official

Name: MRS. JOHANNA MORGAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 808-263-7383