MEDICARE: SHIANNE ERYKA TODD RN, BSN

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	163W00000X	Registered Nurse	95214347	CA
2	163W00000X	Registered Nurse	RN-117815	HI

General Provider Information

NPI Number	:	1700741279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIANNE ERYKA TODD RN, BSN

Provider Business Mailing Address
First Line	:	75-5781 KAKALINA ST
Second Line	:
City	:	KAILUA KONA
State	:	HI
Zip	:	96740-1909
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	73-5618 MAIAU ST STE C200
Second Line	:
City	:	KAILUA KONA
State	:	HI
Zip	:	96740-2635
Country	:	US
Telephone Number	:	808-329-0774
Fax Number	:

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

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	12/17/2025

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