Healthcare Provider Details

I. General information

NPI: 1235773011
Provider Name (Legal Business Name): ROZLYNN KEHAULANI DELA PINA AG-ACNP/APP/APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2019
Last Update Date: 12/15/2021
Certification Date: 12/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 AULIKE ST STE 411
KAILUA HI
96734-2757
US

IV. Provider business mailing address

40 AULIKE ST STE 411
KAILUA HI
96734-2757
US

V. Phone/Fax

Practice location:
  • Phone: 808-452-1379
  • Fax: 808-201-4961
Mailing address:
  • Phone: 808-452-1379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2653
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: