Organization Name: | OCEAN VIEW FAMILY HEALTH CLINIC |
NPI Number: | 1487694071 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VICKIE LYNN CROSBY (CERTIFIED FAMILY NURSE PRACTITIONER) |
Mailing Address: | 92-1471 Aloha Blvd Ocean View |
State: | HI US |
Postal Code: | 967377063 |
Phone Number: | 8089299425 |
Fax Number: | 8089299440 |
NPI Enumeration Date: | 06/08/2006 |
NPI Last Update Date: | 12/04/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | APRN756 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |