Provider Demographics
NPI:1164102984
Name:ACCOUSTI, NEAL OSGOOD (APRN-4100)
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:OSGOOD
Last Name:ACCOUSTI
Suffix:
Gender:M
Credentials:APRN-4100
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 KENOLIO RD
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-9017
Mailing Address - Country:US
Mailing Address - Phone:808-280-9404
Mailing Address - Fax:
Practice Address - Street 1:269 KENOLIO RD
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-9017
Practice Address - Country:US
Practice Address - Phone:808-280-9404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-4100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily