Provider Demographics
NPI:1437255676
Name:HARTWELL-TINDLE, LISA LORENE (PSYD, RN)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:LORENE
Last Name:HARTWELL-TINDLE
Suffix:
Gender:F
Credentials:PSYD, RN
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:LORENE
Other - Last Name:HARTWELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 30554
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96820-0554
Mailing Address - Country:US
Mailing Address - Phone:808-384-3840
Mailing Address - Fax:808-591-9655
Practice Address - Street 1:1268 YOUNG ST
Practice Address - Street 2:SUITE 200
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1801
Practice Address - Country:US
Practice Address - Phone:808-384-3840
Practice Address - Fax:888-352-6787
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY 800103TC0700X
HIRN 30736163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice