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General NPI Number Information
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NPI Number | 1568672038
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Entity Type | Individual
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Provider Name | TERRI LEE IMADA APRN, ANP-C
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1907 S BERETANIA ST KAPIOLANI BREAST CENTER
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City | HONOLULU
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State | HI
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Zip | 96826
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Country | US
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Telephone | 808-973-3152
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Fax | 808-973-4762
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Provider Business Mailing Address
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Address Line | 1907 S BERETANIA ST KAPIOLANI BREAST CENTER
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City | HONOLULU
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State | HI
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Zip | 96826
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Country | US
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Telephone | 808-973-3152
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Fax | 808-973-4762
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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 | APRN-345
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License Number State | HI
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