Provider Demographics
NPI:1184332769
Name:HARA, MIRIE (DNP, APRN-RX, FNP-BC)
Entity type:Individual
Prefix:MISS
First Name:MIRIE
Middle Name:
Last Name:HARA
Suffix:
Gender:F
Credentials:DNP, APRN-RX, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95-1003 KAHELE ST
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-5308
Mailing Address - Country:US
Mailing Address - Phone:808-781-8352
Mailing Address - Fax:
Practice Address - Street 1:95-1003 KAHELE ST
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-5308
Practice Address - Country:US
Practice Address - Phone:808-781-8352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-3852363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily