Provider Demographics
NPI:1942548334
Name:COLLINS, LANDON TYLER (NP)
Entity Type:Individual
Prefix:
First Name:LANDON
Middle Name:TYLER
Last Name:COLLINS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 PUUHONU PL STE 100
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2060
Mailing Address - Country:US
Mailing Address - Phone:808-932-4235
Mailing Address - Fax:088-961-9504
Practice Address - Street 1:HILO BONE & JOINT
Practice Address - Street 2:73 PU'UHONU PL., SUITE 100
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720
Practice Address - Country:US
Practice Address - Phone:088-932-4235
Practice Address - Fax:808-961-9504
Is Sole Proprietor?:No
Enumeration Date:2013-01-21
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1899363LF0000X
HIAPRN1579363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily