Provider Demographics
NPI:1154863496
Name:MCGILL, DENNIS (ARNP)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:
Last Name:MCGILL
Suffix:
Gender:M
Credentials:ARNP
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 1436
Mailing Address - Street 2:
Mailing Address - City:KOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96756-1436
Mailing Address - Country:US
Mailing Address - Phone:808-743-7473
Mailing Address - Fax:949-404-8540
Practice Address - Street 1:5418 NAKOA ST
Practice Address - Street 2:
Practice Address - City:KOLOA
Practice Address - State:HI
Practice Address - Zip Code:96756
Practice Address - Country:US
Practice Address - Phone:808-743-7473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-16
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71008497A363L00000X
KY3010790363L00000X, 364SF0001X
HI3888363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health