Healthcare Provider Details
I. General information
NPI: 1013856590
Provider Name (Legal Business Name): KRYIJZTOFF NOVOTNAJ DNP, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/27/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
44-369 KANEOHE BAY DR
KANEOHE HI
96744-2664
US
IV. Provider business mailing address
44-369 KANEOHE BAY DR
KANEOHE HI
96744-2664
US
V. Phone/Fax
- Phone: 808-862-8796
- Fax:
- Phone: 808-862-8796
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0808X |
| Taxonomy | Psychiatric/Mental Health Registered Nurse |
| License Number | RN59961 |
| License Number State | WY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 14307151-4405 |
| License Number State | UT |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0808X |
| Taxonomy | Psychiatric/Mental Health Registered Nurse |
| License Number | RN825846 |
| License Number State | NV |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | APRN-6103 |
| License Number State | HI |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0808X |
| Taxonomy | Psychiatric/Mental Health Registered Nurse |
| License Number | 100559526 |
| License Number State | OR |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | APRN-CNP89346 |
| License Number State | NM |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | APRN-NP10059526 |
| License Number State | OR |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | APRN-CNP59961 |
| License Number State | WY |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0808X |
| Taxonomy | Psychiatric/Mental Health Registered Nurse |
| License Number | 113720-0 |
| License Number State | HI |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0808X |
| Taxonomy | Psychiatric/Mental Health Registered Nurse |
| License Number | 14307151-3102 |
| License Number State | UT |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0808X |
| Taxonomy | Psychiatric/Mental Health Registered Nurse |
| License Number | 89346 |
| License Number State | NM |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | APRN-CNP825846 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
