Healthcare Provider Details

I. General information

NPI: 1871821041
Provider Name (Legal Business Name): HOB OSTERLUND RN, CNS, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2009
Last Update Date: 11/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4209 KINAU PL
PRINCEVILLE HI
96722-5440
US

IV. Provider business mailing address

4209 KINAU PL
PRINCEVILLE HI
96722-5440
US

V. Phone/Fax

Practice location:
  • Phone: 808-826-6286
  • Fax: 808-826-6286
Mailing address:
  • Phone: 808-826-6286
  • Fax: 808-826-6286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number22549
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number631
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: