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General NPI Number Information
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NPI Number | 1437744232
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Entity Type | Organization
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Legal Business Name | MALAMA KINO PRIMARY CARE INC.
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Dates
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Enumeration Date | 03/03/2021
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Last Update Date | 05/11/2021
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Provider Practice Location Address
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Address Line | 4-1461 KUHIO HWY
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City | KAPAA
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State | HI
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Zip | 96746-1715
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Country | US
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Telephone | 808-320-4333
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Fax |
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Provider Business Mailing Address
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Address Line | 5141 KAPIOLANI LOOP
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City | PRINCEVILLE
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State | HI
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Zip | 96722-5208
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | ALANA R GOO-FRAZIER
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Credential | APRN
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Telephone | 808-320-4333
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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 |
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License Number State |
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