Provider Demographics
NPI:1598735698
Name:NISHIMOTO, PATRICIA WINCK (RN)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:WINCK
Last Name:NISHIMOTO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 HALEKOA DR
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-1039
Mailing Address - Country:US
Mailing Address - Phone:808-734-1812
Mailing Address - Fax:
Practice Address - Street 1:TRIPLER AMC HEM/ONC CLINIC
Practice Address - Street 2:1 JARRETT WHITE ROAD
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96859-5000
Practice Address - Country:US
Practice Address - Phone:808-433-4087
Practice Address - Fax:808-433-2707
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN21083163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology