Provider Demographics
NPI:1174644603
Name:PERRY, RHONDA LYNNE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:LYNNE
Last Name:PERRY
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 IANA ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3410
Mailing Address - Country:US
Mailing Address - Phone:808-263-2383
Mailing Address - Fax:
Practice Address - Street 1:888 S KING ST
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3009
Practice Address - Country:US
Practice Address - Phone:808-522-3781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAMD 032363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical