Provider Demographics
NPI:1508493834
Name:GARRISON, ROBIN LISA (APRN)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:LISA
Last Name:GARRISON
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 1:222 ALIIOLANI ST
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-8312
Mailing Address - Country:US
Mailing Address - Phone:808-463-2210
Mailing Address - Fax:
Practice Address - Street 1:222 ALIIOLANI ST
Practice Address - Street 2:
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-8312
Practice Address - Country:US
Practice Address - Phone:808-463-2210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-25
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-2894363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily