Healthcare Provider Details

I. General information

NPI: 1093780744
Provider Name (Legal Business Name): CHERUB I AKIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 10/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SCHOFIELD BARRACKS HEALTH CLINIC
SCHOFIELD BARRACKS HI
96857-5460
US

IV. Provider business mailing address

91-1022 NIOLO ST
EWA BEACH HI
96706-5115
US

V. Phone/Fax

Practice location:
  • Phone: 270-798-8536
  • Fax: 270-798-8469
Mailing address:
  • Phone: 808-783-5005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30005098
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: