MEDICARE: LYNDA ANNE HIRAKAMI FNP APRN-BC

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	APRN 979	HI

General Provider Information

NPI Number	:	1952586752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNDA ANNE HIRAKAMI FNP APRN-BC

Provider Business Mailing Address
First Line	:	224 HAILI ST STE B
Second Line	:
City	:	HILO
State	:	HI
Zip	:	96720-2975
Country	:	US
Telephone Number	:	808-934-3236
Fax Number	:

Provider Business Practice Location Address
First Line	:	15-2866 PAHOA VILLAGE RD BLDG C
Second Line	:
City	:	PAHOA
State	:	HI
Zip	:	96778-7720
Country	:	US
Telephone Number	:	808-934-3236
Fax Number	:

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

Provider Enumeration Date	:	12/31/2007
Last Update Date	:	03/07/2014

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