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General NPI Number Information
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NPI Number | 1649932625
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Entity Type | Organization
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Legal Business Name | LAINE G NP LLC
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Dates
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Enumeration Date | 10/07/2021
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 1314 S KING ST STE 713
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City | HONOLULU
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State | HI
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Zip | 96814-1942
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Country | US
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Telephone | 808-462-3299
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Fax | 808-888-0924
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Provider Business Mailing Address
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Address Line | 1314 S KING ST STE 713
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City | HONOLULU
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State | HI
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Zip | 96814-1942
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Country | US
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Telephone | 808-462-3299
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Fax | 808-888-0924
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Authorized Official
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Title or Position | OWNER
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Name | MISS LAINE M GUILLOT
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Credential | FNP-BC PMHNP-BC
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Telephone | 504-231-8296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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