Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | APRN2419 | HI |
NPI | 1174076897 |
---|---|
Provider Name | Kyle Fuhriman |
First Address | Hilo, HI 96720-4246 |
Second Address | Hilo, HI 96720-4246 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2016 |
Last Update Date | 14/10/2020 |