Provider Demographics
NPI:1093573701
Name:LONG-USUI, NANCY JAN
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JAN
Last Name:LONG-USUI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6001
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-9167
Mailing Address - Country:US
Mailing Address - Phone:808-286-7105
Mailing Address - Fax:
Practice Address - Street 1:1357 KAPIOLANI BLVD STE 800
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4536
Practice Address - Country:US
Practice Address - Phone:808-523-9043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI17604225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist