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General NPI Number Information
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NPI Number | 1700293248
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Entity Type | Organization
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Legal Business Name | KENYUA N. JOHNSON FNP-BC, LLC
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Dates
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Enumeration Date | 07/16/2014
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Last Update Date | 01/26/2015
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Provider Practice Location Address
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Address Line | 1415 VICTORIA ST APT 205
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City | HONOLULU
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State | HI
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Zip | 96822-3697
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Country | US
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Telephone | 808-292-8028
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Fax | 808-356-0609
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Provider Business Mailing Address
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Address Line | 1415 VICTORIA ST APT 205
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City | HONOLULU
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State | HI
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Zip | 96822-3697
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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 | FAMILY NURSE PRACTITIONER
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Name | MR. KENYUA JOHNSON
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Credential | FNP-BC
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Telephone | 808-216-5179
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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 | APRN1560
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License Number State | HI
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