Provider Demographics
NPI:1639226053
Name:PENNEY, HEATHER FRANCES (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:FRANCES
Last Name:PENNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 MAKIKI ST
Mailing Address - Street 2:APT 112
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-4488
Mailing Address - Country:US
Mailing Address - Phone:808-732-2680
Mailing Address - Fax:
Practice Address - Street 1:1130 N NIMITZ HWY
Practice Address - Street 2:SUITE NUMBER A-224
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-4579
Practice Address - Country:US
Practice Address - Phone:808-536-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0579082085R0202X
HI13632208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
1750361697Medicare UPIN