Provider Demographics
NPI:1619390960
Name:TANZER, BRIGITTA (FNP-C)
Entity Type:Individual
Prefix:
First Name:BRIGITTA
Middle Name:
Last Name:TANZER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2470 S KING ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-5808
Mailing Address - Country:US
Mailing Address - Phone:808-947-2651
Mailing Address - Fax:
Practice Address - Street 1:2470 S KING ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-5808
Practice Address - Country:US
Practice Address - Phone:808-947-2651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-22
Last Update Date:2019-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-1891363LF0000X
HI1891363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS77913OtherNP LICENSE
HI1891OtherNP LICENSE (BOARD OF NURSING)