Provider Demographics
NPI:1003654849
Name:TOBIS, JENNIFER AYUMI (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:AYUMI
Last Name:TOBIS
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:AYUMI
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:287 ALIIOLANI ST
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-8329
Mailing Address - Country:US
Mailing Address - Phone:808-500-2248
Mailing Address - Fax:
Practice Address - Street 1:270 DAIRY RD STE 239
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2986
Practice Address - Country:US
Practice Address - Phone:808-667-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-4665-0363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily