Healthcare Provider Details

I. General information

NPI: 1770104911
Provider Name (Legal Business Name): CELESTE INDVIK BROWN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CELESTE DANIELLE INDVIK

II. Dates (important events)

Enumeration Date: 04/28/2020
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date: 07/12/2024
Reactivation Date: 07/31/2024

III. Provider practice location address

2-2527 KAUMUALII HWY
KALAHEO HI
96741-8309
US

IV. Provider business mailing address

316 MID VALLEY CTR STE 186
CARMEL CA
93923-8516
US

V. Phone/Fax

Practice location:
  • Phone: 808-332-5580
  • Fax: 808-332-5581
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-4669
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: