Provider Demographics
NPI:1891727665
Name:NESBITT, CONSTANCE S (MD)
Entity Type:Individual
Prefix:DR
First Name:CONSTANCE
Middle Name:S
Last Name:NESBITT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86-260 FARRINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-3128
Mailing Address - Country:US
Mailing Address - Phone:808-697-3433
Mailing Address - Fax:808-697-3575
Practice Address - Street 1:86-260 FARRINGTON HWY
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-3128
Practice Address - Country:US
Practice Address - Phone:808-697-3433
Practice Address - Fax:808-697-3575
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-7729208000000X
HIMD-14037208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR195311001Medicaid
HIMD-14037Medicaid
102202Medicare UPIN
LA4F802Medicare ID - Type Unspecified