Basic Information
| Provider Information | |||||||||
| NPI: | 1508206863 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TABA | ||||||||
| FirstName: | ROBYN | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | DNP, MBA, APRN, FNPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2470 S KING ST | ||||||||
| Address2: | CLINIC #9954 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968265808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089472651 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2470 S. KING ST. | ||||||||
| Address2: | CLINIC #9954 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968165808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089472651 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2013 | ||||||||
| LastUpdateDate: | 03/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 3081 | HI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 163W00000X | 85540 | HI | N | Nursing Service Providers | Registered Nurse | 2255A2300X | 28 | HI | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.