Healthcare Provider Details

I. General information

NPI: 1487694071
Provider Name (Legal Business Name): OCEAN VIEW FAMILY HEALTH CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 12/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92-1471 ALOHA BLVD
OCEAN VIEW HI
96737-7063
US

IV. Provider business mailing address

PO BOX 7009
OCEAN VIEW HI
96737-7009
US

V. Phone/Fax

Practice location:
  • Phone: 808-929-9425
  • Fax: 808-929-9440
Mailing address:
  • Phone: 808-929-9425
  • Fax: 808-929-9440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN756
License Number StateHI

VIII. Authorized Official

Name: VICKIE LYNN CROSBY
Title or Position: CERTIFIED FAMILY NURSE PRACTITIONER
Credential: APRN
Phone: 808-929-9425