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General NPI Number Information
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NPI Number | 1508190588
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Entity Type | Individual
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Provider Name | CRISTINA ELIZABETH PROKOP A.P.R.N.
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Gender | Female
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Dates
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Enumeration Date | 09/24/2009
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Last Update Date | 03/19/2011
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Provider Practice Location Address
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Address Line | 81 MAKAWAO AVE STE 100
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City | MAKAWAO
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State | HI
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Zip | 96768-8859
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Country | US
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Telephone | 808-573-8900
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Fax | 808-572-3027
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Provider Business Mailing Address
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Address Line | 81 MAKAWAO AVE STE 100
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City | MAKAWAO
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State | HI
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Zip | 96768-8859
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Country | US
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Telephone | 808-573-8900
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Fax | 808-572-3027
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 1124
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License Number State | HI
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