Basic Information
| Provider Information | |||||||||
| NPI: | 1467459701 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALOHA NURSE ANESTHESIA SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1840 | ||||||||
| Address2: | |||||||||
| City: | KAILUA KONA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967451840 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8083256760 | ||||||||
| FaxNumber: | 8084430159 | ||||||||
| Practice Location | |||||||||
| Address1: | 3420 KUHIO HIGHWAY | ||||||||
| Address2: | |||||||||
| City: | LIHUE | ||||||||
| State: | HI | ||||||||
| PostalCode: | 96766 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082451100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | RAMEY | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | VP | ||||||||
| AuthorizedOfficialTelephone: | 8083320127 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | CRNA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | APRN192 | HI | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.