Provider Demographics
NPI:1386854412
Name:TAKAHASHI, RUBY M (NP)
Entity Type:Individual
Prefix:MS
First Name:RUBY
Middle Name:M
Last Name:TAKAHASHI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:1355 MOANALUALANI PL APT C
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-1212
Mailing Address - Country:US
Mailing Address - Phone:808-834-7105
Mailing Address - Fax:
Practice Address - Street 1:1301 PUNCHBOWL ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2402
Practice Address - Country:US
Practice Address - Phone:808-547-4533
Practice Address - Fax:808-537-7853
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIAPRN 218363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner