Provider Demographics
NPI:1174025449
Name:VAZQUEZ ARROYO, NERISSA BOW KAM (FNP-BC, APRN)
Entity Type:Individual
Prefix:
First Name:NERISSA
Middle Name:BOW KAM
Last Name:VAZQUEZ ARROYO
Suffix:
Gender:F
Credentials:FNP-BC, APRN
Other - Prefix:
Other - First Name:NERISSA
Other - Middle Name:BOW KAM
Other - Last Name:FUKUDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 S BERETANIA ST STE 501
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2496
Mailing Address - Country:US
Mailing Address - Phone:808-691-8838
Mailing Address - Fax:
Practice Address - Street 1:550 S BERETANIA ST STE 501
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2496
Practice Address - Country:US
Practice Address - Phone:808-691-8838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-02
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-2402363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily