Provider Demographics
NPI:1326735929
Name:EVOLVE HEALTH LLC
Entity Type:Organization
Organization Name:EVOLVE HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP,APRN,DNP
Authorized Official - Phone:808-452-1731
Mailing Address - Street 1:1188 BISHOP ST STE 1603
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3306
Mailing Address - Country:US
Mailing Address - Phone:808-452-1731
Mailing Address - Fax:808-452-1741
Practice Address - Street 1:1188 BISHOP ST STE 1603
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3306
Practice Address - Country:US
Practice Address - Phone:808-452-1731
Practice Address - Fax:808-452-1741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty