Provider Demographics
NPI:1053483180
Name:MCCANN, CAROL LOUISE (FNP)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:LOUISE
Last Name:MCCANN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:385 WANAAO RD
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3467
Mailing Address - Country:US
Mailing Address - Phone:808-433-1713
Mailing Address - Fax:808-433-1471
Practice Address - Street 1:1 JARRETT WHITE ROAD
Practice Address - Street 2:TRIPLER ARMY MEDICAL CENTER
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96859
Practice Address - Country:US
Practice Address - Phone:808-433-1713
Practice Address - Fax:808-433-1471
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIRN46612363LF0000X
HIAPRN -961363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily