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General NPI Number Information
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NPI Number | 1225781081
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Entity Type | Individual
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Provider Name | WILMA CARON
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Gender | Female
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Dates
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Enumeration Date | 02/01/2022
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 1552 THURSTON AVE APT 12
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City | HONOLULU
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State | HI
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Zip | 96822-3711
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Country | US
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Telephone | 808-308-9794
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Fax |
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Provider Business Mailing Address
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Address Line | 1552 THURSTON AVE APT 12
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City | HONOLULU
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State | HI
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Zip | 96822-3711
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Country | US
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Telephone | 808-308-9794
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN-3528-0
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License Number State | HI
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