Provider Demographics
NPI:1033349477
Name:CHOUCAIR, LISE MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:LISE
Middle Name:MARIE
Last Name:CHOUCAIR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 ULUKAHIKI ST
Mailing Address - Street 2:#103
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4400
Mailing Address - Country:US
Mailing Address - Phone:808-263-5174
Mailing Address - Fax:
Practice Address - Street 1:4224 WAIALAE AVE # 702
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5330
Practice Address - Country:US
Practice Address - Phone:877-445-4406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-1014163W00000X
HIRN-54293363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00A0280394OtherHMSA