Healthcare Provider Details

I. General information

NPI: 1982250015
Provider Name (Legal Business Name): MARILEE KUULEI OWENS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2019
Last Update Date: 07/28/2023
Certification Date: 07/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 N KALAHEO AVE STE C306
KAILUA HI
96734-1873
US

IV. Provider business mailing address

970 N KALAHEO AVE STE C306
KAILUA HI
96734-1873
US

V. Phone/Fax

Practice location:
  • Phone: 808-263-7383
  • Fax: 808-237-5828
Mailing address:
  • Phone: 808-263-7383
  • Fax: 808-237-5828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-2763
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: