Provider Demographics
NPI:1932683273
Name:FRIED, DEBORAH MICHIKO (APRN)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:MICHIKO
Last Name:FRIED
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 KILUA RD
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-1420
Mailing Address - Country:US
Mailing Address - Phone:808-934-0720
Mailing Address - Fax:
Practice Address - Street 1:101 AUPUNI ST STE 217
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4221
Practice Address - Country:US
Practice Address - Phone:808-427-4133
Practice Address - Fax:808-427-6087
Is Sole Proprietor?:No
Enumeration Date:2018-09-22
Last Update Date:2023-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-2535363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily