Provider Demographics
NPI:1881354876
Name:HOLSCHUH, TIMOTHY CARROLL (FNP)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:CARROLL
Last Name:HOLSCHUH
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:MR
Other - First Name:TIMOTHY
Other - Middle Name:CARROLL
Other - Last Name:HOLSCHUH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:46-3599 KAHANA DR
Mailing Address - Street 2:
Mailing Address - City:HONOKAA
Mailing Address - State:HI
Mailing Address - Zip Code:96727-7009
Mailing Address - Country:US
Mailing Address - Phone:808-936-5559
Mailing Address - Fax:
Practice Address - Street 1:46-3599 KAHANA DR
Practice Address - Street 2:
Practice Address - City:HONOKAA
Practice Address - State:HI
Practice Address - Zip Code:96727-7009
Practice Address - Country:US
Practice Address - Phone:808-936-5559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-18
Last Update Date:2021-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3431-0363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily