Provider Demographics
NPI:1255421509
Name:ZORN, CHERYL (APRN)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:ZORN
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 1:224 HAILI ST STE B
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2975
Mailing Address - Country:US
Mailing Address - Phone:808-961-4072
Mailing Address - Fax:808-961-5678
Practice Address - Street 1:15-2866 PAHOA VILLAGE RD.
Practice Address - Street 2:
Practice Address - City:PAHOA
Practice Address - State:HI
Practice Address - Zip Code:96778-1455
Practice Address - Country:US
Practice Address - Phone:808-965-9711
Practice Address - Fax:808-965-6240
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN891363LF0000X
MNR139942-2163W00000X
HIRN 58036163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH102322Medicare PIN
HIH102323Medicare PIN
HIH102324Medicare PIN
HIH102321Medicare PIN
HIP82759Medicare UPIN