MEDICARE: JENNIFER ANNE IVANOVNA LAHOV ARNP, FNP-C, CPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP61207026	WA
2	163WG0000X	General Practice Registered Nurse	RN-120641	HI
3	163WM0705X	Medical-Surgical Registered Nurse	RN61207021	WA
4	363LF0000X	Family Nurse Practitioner	APRN-4729	HI

General Provider Information

NPI Number	:	1255113601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ANNE IVANOVNA LAHOV ARNP, FNP-C, CPH

Provider Business Mailing Address
First Line	:	456 KIHAPAI ST
Second Line	:
City	:	KAILUA
State	:	HI
Zip	:	96734-2444
Country	:	US
Telephone Number	:	908-752-7443
Fax Number	:

Provider Business Practice Location Address
First Line	:	91-6390 KAPOLEI PKWY
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-6380
Country	:	US
Telephone Number	:	808-691-7482
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2023
Last Update Date	:	09/11/2025

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