Provider Demographics
NPI:1255937074
Name:REECE, ELYSE (DNP, RN, FNP-BC)
Entity type:Individual
Prefix:
First Name:ELYSE
Middle Name:
Last Name:REECE
Suffix:
Gender:F
Credentials:DNP, RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 KAILUA RD STE 111
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3420
Mailing Address - Country:US
Mailing Address - Phone:808-261-4411
Mailing Address - Fax:
Practice Address - Street 1:130 KAILUA RD STE 111
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-3420
Practice Address - Country:US
Practice Address - Phone:808-261-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-2962363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily