Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 2234 | HI |
NPI | 1003348665 |
---|---|
Provider Name | Ms. Heather Salvador |
First Address | Waianae, HI 96792-3128 |
Second Address | Waianae, HI 96792-3128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2017 |
Last Update Date | 31/03/2017 |