Provider Demographics
NPI:1891395034
Name:HAMADA, LIANA NICOLE (NP)
Entity Type:Individual
Prefix:
First Name:LIANA
Middle Name:NICOLE
Last Name:HAMADA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3375 PAWAINA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-1352
Mailing Address - Country:US
Mailing Address - Phone:808-375-7360
Mailing Address - Fax:
Practice Address - Street 1:405 N KUAKINI ST STE 601
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-6302
Practice Address - Country:US
Practice Address - Phone:808-686-4655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIARPN-3068363L00000X
HIAPRN-3068363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner