Provider Demographics
NPI:1235259706
Name:AUYONG, GWEN EMIKO (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:GWEN
Middle Name:EMIKO
Last Name:AUYONG
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:46-255 KAHUHIPA ST APT A1202
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-6083
Mailing Address - Country:US
Mailing Address - Phone:808-247-9353
Mailing Address - Fax:808-235-1973
Practice Address - Street 1:9900 BREN ROAD EAST
Practice Address - Street 2:MAIL ROUTE MN 008-B213
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343
Practice Address - Country:US
Practice Address - Phone:808-694-9596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-728363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily