Provider Demographics
NPI:1851523211
Name:OMATSU, DEE ANN K (PNP)
Entity Type:Individual
Prefix:MS
First Name:DEE ANN
Middle Name:K
Last Name:OMATSU
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:MS
Other - First Name:DEE ANN
Other - Middle Name:K
Other - Last Name:FU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PNP
Mailing Address - Street 1:1946 YOUNG ST
Mailing Address - Street 2:SUITE 320
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-2169
Mailing Address - Country:US
Mailing Address - Phone:808-973-7320
Mailing Address - Fax:808-973-7325
Practice Address - Street 1:1319 PUNAHOU ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1001
Practice Address - Country:US
Practice Address - Phone:808-983-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-19
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-1167363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics