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General NPI Number Information
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NPI Number | 1194524900
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Entity Type | Organization
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Legal Business Name | BLUE OCEAN PSYCHIATRY LLC
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 1441 KAPIOLANI BLVD
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City | HONOLULU
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State | HI
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Zip | 96814-4402
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Country | US
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Telephone | 901-412-2598
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Fax |
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Provider Business Mailing Address
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Address Line | 7247 CREATHWOOD CV
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City | GERMANTOWN
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State | TN
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Zip | 38138-5711
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Country | US
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Telephone | 901-412-2598
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Fax |
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Authorized Official
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Title or Position | PMHNP
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Name | MIKI CAMPBELL
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Credential |
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Telephone | 901-412-2598
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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