Provider Demographics
NPI:1477535854
Name:ALLISON, DALE A (APRN)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:A
Last Name:ALLISON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:758 KAPAHULU AVE
Mailing Address - Street 2:#A-319
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1196
Mailing Address - Country:US
Mailing Address - Phone:808-922-4787
Mailing Address - Fax:808-922-4950
Practice Address - Street 1:277 OHUA AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-3643
Practice Address - Country:US
Practice Address - Phone:808-922-4787
Practice Address - Fax:808-922-4950
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN 71363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI50211301Medicaid
HI0000231001OtherHMSA
HI50211301OtherALOHA CARE
HIP53719Medicare UPIN
HI50211301Medicaid