Provider Demographics
NPI:1750826962
Name:MAGORNO, SUSAN MARIE (DNP, APRN, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MARIE
Last Name:MAGORNO
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
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Mailing Address - Street 1:46-318 NAHEWAI STREET
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744
Mailing Address - Country:US
Mailing Address - Phone:808-562-4041
Mailing Address - Fax:888-518-4443
Practice Address - Street 1:500 ALA MOANA BLVD
Practice Address - Street 2:SUITE 7400
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4902
Practice Address - Country:US
Practice Address - Phone:808-562-4041
Practice Address - Fax:888-518-4443
Is Sole Proprietor?:No
Enumeration Date:2016-12-23
Last Update Date:2024-10-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA95011949363LP0808X
HIAPRN-2536363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health