Provider Demographics
NPI:1467236851
Name:BIENEMAN, TANYA ELAINE (FNP)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:ELAINE
Last Name:BIENEMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 OHUKAI RD STE 414
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7060
Mailing Address - Country:US
Mailing Address - Phone:765-418-5482
Mailing Address - Fax:
Practice Address - Street 1:320 OHUKAI RD
Practice Address - Street 2:SUITE 414
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753
Practice Address - Country:US
Practice Address - Phone:765-418-5482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-4153363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily