Provider Demographics
NPI:1821887811
Name:HALL, KRISTEN (APRN)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:HALL
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55-497 KAMEHAMEHA HWY APT D
Mailing Address - Street 2:
Mailing Address - City:LAIE
Mailing Address - State:HI
Mailing Address - Zip Code:96762-1143
Mailing Address - Country:US
Mailing Address - Phone:808-561-2273
Mailing Address - Fax:
Practice Address - Street 1:54-010 KUKUNA ST
Practice Address - Street 2:
Practice Address - City:HAUULA
Practice Address - State:HI
Practice Address - Zip Code:96717-9628
Practice Address - Country:US
Practice Address - Phone:808-255-6944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI5210-0363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily