Provider Demographics
NPI:1982250015
Name:OWENS, MARILEE KUULEI (NP)
Entity Type:Individual
Prefix:
First Name:MARILEE
Middle Name:KUULEI
Last Name:OWENS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 N KALAHEO AVE STE C306
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1873
Mailing Address - Country:US
Mailing Address - Phone:808-263-7383
Mailing Address - Fax:808-237-5828
Practice Address - Street 1:970 N KALAHEO AVE STE C306
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-1873
Practice Address - Country:US
Practice Address - Phone:808-263-7383
Practice Address - Fax:808-237-5828
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-2763363LF0000X
TXAP141934363LF0000X
OR202010257NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500791512Medicaid