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General NPI Number Information
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NPI Number | 1265753826
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Entity Type | Individual
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Provider Name | PRINCESS BAUTISTA-MONTEREY CANIDA APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/17/2010
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 868 ULULANI ST STE 108
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City | HILO
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State | HI
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Zip | 96720-3913
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Country | US
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Telephone | 808-935-2389
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7549
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City | HILO
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State | HI
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Zip | 96720-8946
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Country | US
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Telephone | 808-935-2389
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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-5562
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 163WM0102X
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Taxonomy Name | Maternal Newborn Registered Nurse
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License Number | RN-75756
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License Number State | HI
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