Provider Demographics
NPI:1801962337
Name:CHABORA, NIDHI ANNA (APRN-RX)
Entity type:Individual
Prefix:MS
First Name:NIDHI
Middle Name:ANNA
Last Name:CHABORA
Suffix:
Gender:F
Credentials:APRN-RX
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1400
Mailing Address - Street 2:
Mailing Address - City:HONOKAA
Mailing Address - State:HI
Mailing Address - Zip Code:96727-1400
Mailing Address - Country:US
Mailing Address - Phone:808-775-8835
Mailing Address - Fax:808-775-8834
Practice Address - Street 1:45-3380 MAMANE ST
Practice Address - Street 2:SUITE #4
Practice Address - City:HONOKAA
Practice Address - State:HI
Practice Address - Zip Code:96727-6933
Practice Address - Country:US
Practice Address - Phone:808-775-8835
Practice Address - Fax:808-775-8834
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-RX 140363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI53884501OtherALOHA CARE -HONOKAA
HI0000244871OtherHMSA
HI0000519118Medicaid
HI53884502OtherALOHA CARE - KAMUELA
HI0000519118Medicaid
HI0000244871OtherHMSA