Provider Demographics
NPI:1154630473
Name:CUMMINGS, MANDI TE BENTON (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:MANDI
Middle Name:TE BENTON
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:MANDI
Other - Middle Name:TE
Other - Last Name:BENTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 S BERETANIA ST STE 601
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2423
Mailing Address - Country:US
Mailing Address - Phone:808-429-3635
Mailing Address - Fax:
Practice Address - Street 1:1301 PUNCHBOWL ST
Practice Address - Street 2:QUEENS HEART, PAUAHI 3
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2402
Practice Address - Country:US
Practice Address - Phone:808-547-4468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-1301363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health