Provider Demographics
NPI:1750635157
Name:WHITAKER, NAOMI SUMMER (APNP)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:SUMMER
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:NAOMI
Other - Middle Name:SUMMER
Other - Last Name:LANDRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:75-5751 KUAKINI HWY STE 203
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-1753
Mailing Address - Country:US
Mailing Address - Phone:808-333-3600
Mailing Address - Fax:808-961-5167
Practice Address - Street 1:95-5583 MAMALAHOA HWY
Practice Address - Street 2:
Practice Address - City:NA'ALEHU
Practice Address - State:HI
Practice Address - Zip Code:96772
Practice Address - Country:US
Practice Address - Phone:808-333-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-2571363LF0000X
WI5133363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily