Provider Demographics
NPI:1609892900
Name:CARMICHAEL WALSH, MARNE J (MS,PA-C)
Entity Type:Individual
Prefix:
First Name:MARNE
Middle Name:J
Last Name:CARMICHAEL WALSH
Suffix:
Gender:F
Credentials:MS,PA-C
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Mailing Address - Street 1:64-1035 MAMALAHOA HIGHWAY, SUITE J AND K
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743
Mailing Address - Country:US
Mailing Address - Phone:808-885-4503
Mailing Address - Fax:808-885-4517
Practice Address - Street 1:670 PONAHAWAI ST STE 224
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-7829
Practice Address - Country:US
Practice Address - Phone:808-300-1064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2020-09-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HI273363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant