Provider Demographics
NPI:1063205136
Name:BITANGA, CHARLYN MARIE
Entity type:Individual
Prefix:
First Name:CHARLYN
Middle Name:MARIE
Last Name:BITANGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHARLI
Other - Middle Name:
Other - Last Name:BITANGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN-RX, PMHNP
Mailing Address - Street 1:2792 REEVES RD
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4911
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:459 PATTERSON RD
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-1522
Practice Address - Country:US
Practice Address - Phone:760-420-9273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-5127363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health