Provider Demographics
NPI:1740408459
Name:ONO, CHARLENE KIYOMI (APRN-RX)
Entity Type:Individual
Prefix:MS
First Name:CHARLENE
Middle Name:KIYOMI
Last Name:ONO
Suffix:
Gender:F
Credentials:APRN-RX
Other - Prefix:
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Mailing Address - Street 1:6785C OLOHENA RD
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-8718
Mailing Address - Country:US
Mailing Address - Phone:808-822-1696
Mailing Address - Fax:
Practice Address - Street 1:3-1901 KAUMUALII HWY
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-9500
Practice Address - Country:US
Practice Address - Phone:808-245-8310
Practice Address - Fax:808-245-8298
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIAPRN-423363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI231696Medicare UPIN