Provider Demographics
NPI:1023043312
Name:CHONG TIM, LINDA S (CNM)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:CHONG TIM
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45-602 KAMEHAMEHA HWY
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2017
Mailing Address - Country:US
Mailing Address - Phone:808-432-3800
Mailing Address - Fax:
Practice Address - Street 1:45-602 KAMEHAMEHA HWY
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-2017
Practice Address - Country:US
Practice Address - Phone:808-432-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN148367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI546517Medicaid
HI0218909OtherHMSA
HI546517-05Medicaid
HI00C0218903OtherHMSA BILLING NUMBER
HI0218909OtherHMSA
HI546517Medicaid