Provider Demographics
NPI:1245841931
Name:DANKS, KIMBERLY VICTORIA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:VICTORIA
Last Name:DANKS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:111 HEKILI ST STE A291
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2800
Mailing Address - Country:US
Mailing Address - Phone:808-295-7824
Mailing Address - Fax:
Practice Address - Street 1:30 AULIKE ST STE 500
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2752
Practice Address - Country:US
Practice Address - Phone:808-263-8822
Practice Address - Fax:808-261-6749
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-2926363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty