Provider Demographics
NPI:1083366371
Name:KUPUNA MOBILE HEALTH
Entity Type:Organization
Organization Name:KUPUNA MOBILE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PUEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-359-1641
Mailing Address - Street 1:PO BOX 831134
Mailing Address - Street 2:
Mailing Address - City:PEPEEKEO
Mailing Address - State:HI
Mailing Address - Zip Code:96783-1072
Mailing Address - Country:US
Mailing Address - Phone:808-359-1641
Mailing Address - Fax:800-884-6702
Practice Address - Street 1:28-787 KAUPAKUEA HOMESTEAD RD
Practice Address - Street 2:
Practice Address - City:PEPEEKEO
Practice Address - State:HI
Practice Address - Zip Code:96783
Practice Address - Country:US
Practice Address - Phone:808-359-1641
Practice Address - Fax:800-884-6702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty