Healthcare Provider Details

I. General information

NPI: 1275997025
Provider Name (Legal Business Name): AMY NAKAMA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2016
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 MAUI LANI PKWY
WAILUKU HI
96793-2416
US

IV. Provider business mailing address

85 MAUI LANI PKWY
WAILUKU HI
96793-2416
US

V. Phone/Fax

Practice location:
  • Phone: 808-244-5366
  • Fax: 855-827-2321
Mailing address:
  • Phone: 808-244-5366
  • Fax: 855-827-2321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-2646
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-63615
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: