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General NPI Number Information
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NPI Number | 1912730235
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Entity Type | Individual
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Provider Name | MILDRED TANG
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Gender | Female
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Dates
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Enumeration Date | 08/22/2024
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 683 WAIANAE AVE BLDG 677, 1ST FLOOR
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City | SCHOFIELD BARRACKS
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State | HI
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Zip | 96857
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Country | US
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Telephone | 808-433-8641
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Fax | 808-433-8217
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Provider Business Mailing Address
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Address Line | 95-209 HALEPULE PL
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City | MILILANI
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State | HI
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Zip | 96789-6579
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Country | US
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Telephone | 808-636-5049
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Fax |
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | RN56044
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License Number State | HI
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