Provider Demographics
NPI:1376612010
Name:RONNFELDT, HEIDI MARIE
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:MARIE
Last Name:RONNFELDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SAND ISLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-4326
Mailing Address - Country:US
Mailing Address - Phone:808-433-9800
Mailing Address - Fax:
Practice Address - Street 1:400 SAND ISLAND PKWY
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-4326
Practice Address - Country:US
Practice Address - Phone:808-433-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider