Provider Demographics
NPI:1558833111
Name:BACCHUS, FRANCES ASTORGA (MSN, NP-C)
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:ASTORGA
Last Name:BACCHUS
Suffix:
Gender:F
Credentials:MSN, NP-C
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1300 N HOLOPONO ST STE 215
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-6945
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1300 N HOLOPONO ST STE 215
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-6945
Practice Address - Country:US
Practice Address - Phone:808-874-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIAPRN-2567363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner