Healthcare Provider Details

I. General information

NPI: 1558698878
Provider Name (Legal Business Name): KRISTI YEAROUT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2009
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65-1267 KAWAIHAE ROAD
KAMUELA HI
96743
US

IV. Provider business mailing address

75 PUUHONU PL STE 101
HILO HI
96720-2000
US

V. Phone/Fax

Practice location:
  • Phone: 808-881-4658
  • Fax: 808-881-4684
Mailing address:
  • Phone: 808-769-4197
  • Fax: 808-213-6706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number72342
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1475
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: