Provider Demographics
NPI:1649735671
Name:ALFORD, COLLEEN SANDERS (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:SANDERS
Last Name:ALFORD
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 BISHOP ST STE 414
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4824
Mailing Address - Country:US
Mailing Address - Phone:808-888-5683
Mailing Address - Fax:808-888-5683
Practice Address - Street 1:735 BISHOP ST STE 414
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4824
Practice Address - Country:US
Practice Address - Phone:808-217-0129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-04
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA761063163W00000X
HI3660363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse