Provider Demographics
NPI:1184606899
Name:DUERLER, AMY J (APRN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:J
Last Name:DUERLER
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 1:64-1032 MAMALAHOA HWY 306
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-8441
Mailing Address - Country:US
Mailing Address - Phone:808-769-5010
Mailing Address - Fax:808-769-5208
Practice Address - Street 1:16-192 PILI MUA ST
Practice Address - Street 2:
Practice Address - City:KEAAU
Practice Address - State:HI
Practice Address - Zip Code:96749-8134
Practice Address - Country:US
Practice Address - Phone:808-930-0400
Practice Address - Fax:808-966-4028
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN 841363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIPENDINGMedicaid
HIPENDINGMedicare UPIN
HIPENDINGMedicaid