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General NPI Number Information
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NPI Number | 1952205049
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Entity Type | Organization
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Legal Business Name | OCEAN DEEP NOURISHMENT CO. LLC
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 91-829 OANIANI ST
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City | KAPOLEI
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State | HI
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Zip | 96707-2645
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Country | US
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Telephone | 636-699-7822
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Fax |
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Provider Business Mailing Address
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Address Line | 91-829 OANIANI ST
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City | KAPOLEI
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State | HI
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Zip | 96707-2645
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Country | US
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Telephone | 636-699-7822
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Fax |
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Authorized Official
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Title or Position | OWNER AND REGISTERED DIETITIAN
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Name | ANGELA HIGGINS
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Credential | RDN
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Telephone | 636-699-7822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State | NULL
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