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General NPI Number Information
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NPI Number | 1962926832
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Entity Type | Organization
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Legal Business Name | KORU HEALTH AND BEAUTY, LLC
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 64-1035 MAMALAHOA HWY STE J
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City | KAMUELA
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State | HI
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Zip | 96743-8440
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Country | US
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Telephone | 808-323-2608
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Fax | 808-885-9793
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Provider Business Mailing Address
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Address Line | 64-1035 MAMALAHOA HWY STE J
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City | KAMUELA
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State | HI
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Zip | 96743-8440
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Country | US
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Telephone | 808-323-2608
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DR. SHELLIE RENEE NORMAN
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Credential | APRN
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Telephone | 808-339-3595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1841
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License Number State | HI
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