Provider Demographics
NPI:1225774466
Name:PETER, KALIF C (MSN, AG-ACNP)
Entity Type:Individual
Prefix:MR
First Name:KALIF
Middle Name:C
Last Name:PETER
Suffix:
Gender:M
Credentials:MSN, AG-ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-2135 FORT WEAVER RD FL 3
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-1940
Mailing Address - Country:US
Mailing Address - Phone:808-691-3340
Mailing Address - Fax:808-691-3345
Practice Address - Street 1:91-2135 FORT WEAVER RD FL 3
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-1940
Practice Address - Country:US
Practice Address - Phone:808-691-3340
Practice Address - Fax:808-691-3345
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-10
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3653363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care