Provider Demographics
NPI:1184108045
Name:MUKISA, DORIS MUGUME (PMHNP)
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:MUGUME
Last Name:MUKISA
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 DEATON TRL
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-1107
Mailing Address - Country:US
Mailing Address - Phone:781-354-5513
Mailing Address - Fax:
Practice Address - Street 1:928 NUUANU AVE STE 202
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-5190
Practice Address - Country:US
Practice Address - Phone:808-777-9460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN272948163WP0809X
HIAPRN-5143-0363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult