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General NPI Number Information
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NPI Number | 1821223124
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Entity Type | Organization
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Legal Business Name | KONA NPS LLC
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Dates
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Enumeration Date | 05/16/2009
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Last Update Date | 05/16/2009
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Provider Practice Location Address
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Address Line | 74-5027 TOMI TOMI DR # A
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City | KAILUA KONA
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State | HI
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Zip | 96740-8114
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Country | US
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Telephone | 808-987-4506
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Fax | 808-326-9071
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Provider Business Mailing Address
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Address Line | 74-5027 TOMI TOMI DR # A
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City | KAILUA KONA
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State | HI
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Zip | 96740-8114
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Country | US
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Telephone | 808-987-4506
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Fax | 808-326-9071
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Authorized Official
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Title or Position | MEMBER OWNER
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Name | RONDA K SOTO
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Credential | NP
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Telephone | 808-987-4506
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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 677
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License Number State | HI
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