Provider Demographics
NPI:1689829020
Name:TANIGAWA, COURTNY ELIZABETH (APRN)
Entity Type:Individual
Prefix:MS
First Name:COURTNY
Middle Name:ELIZABETH
Last Name:TANIGAWA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:COURTNY
Other - Middle Name:ELIZABETH
Other - Last Name:EAST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1778 BERTRAM STREET
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816
Mailing Address - Country:US
Mailing Address - Phone:808-671-8511
Mailing Address - Fax:808-677-2570
Practice Address - Street 1:91-1010 SHANGRILLA STREET
Practice Address - Street 2:KALAELOA PROFESSIONAL CENTER
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707
Practice Address - Country:US
Practice Address - Phone:808-381-2267
Practice Address - Fax:808-677-2570
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN 735363LF0000X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult