Provider Demographics
NPI:1467099481
Name:NP PROVIDER1, LLC
Entity Type:Organization
Organization Name:NP PROVIDER1, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELUNED
Authorized Official - Middle Name:
Authorized Official - Last Name:MUN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-RX
Authorized Official - Phone:808-208-0434
Mailing Address - Street 1:46-064 ALIIKANE PL APT 2022
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3708
Mailing Address - Country:US
Mailing Address - Phone:808-208-0434
Mailing Address - Fax:
Practice Address - Street 1:46-064 ALIIKANE PL APT 2022
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3708
Practice Address - Country:US
Practice Address - Phone:808-208-0434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-10
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home