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General NPI Number Information
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NPI Number | 1467075614
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Entity Type | Individual
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Provider Name | HENRY LOU-GOODE APRN
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Gender | Male
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Dates
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Enumeration Date | 05/22/2020
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 50 S BERETANIA ST STE C112
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City | HONOLULU
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State | HI
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Zip | 96813-2225
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Country | US
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Telephone | 808-466-2979
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Fax |
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Provider Business Mailing Address
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Address Line | 92-836 KINOHI PL APT 16
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City | KAPOLEI
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State | HI
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Zip | 96707-1336
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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 |
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN104290
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN3507
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License Number State | HI
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