Provider Demographics
NPI:1619861945
Name:GIBSON, OLIVIA (APRN)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:GIBSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:
Other - Last Name:PRINDLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:67-221 NIUMALOO PL
Mailing Address - Street 2:
Mailing Address - City:WAIALUA
Mailing Address - State:HI
Mailing Address - Zip Code:96791-9507
Mailing Address - Country:US
Mailing Address - Phone:808-255-1736
Mailing Address - Fax:
Practice Address - Street 1:67-221 NIUMALOO PL
Practice Address - Street 2:
Practice Address - City:WAIALUA
Practice Address - State:HI
Practice Address - Zip Code:96791-9507
Practice Address - Country:US
Practice Address - Phone:808-255-1736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-5200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily