Basic Information
| Provider Information | |||||||||
| NPI: | 1619390960 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TANZER | ||||||||
| FirstName: | BRIGITTA | ||||||||
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| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2470 S KING ST | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968265808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089472651 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2470 S KING ST | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968265808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089472651 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2014 | ||||||||
| LastUpdateDate: | 05/05/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APRN-1891 | HI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 77913 | 01 | KS | NP LICENSE | OTHER |