Provider Demographics
NPI:1487694071
Name:OCEAN VIEW FAMILY HEALTH CLINIC
Entity type:Organization
Organization Name:OCEAN VIEW FAMILY HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:808-929-9425
Mailing Address - Street 1:PO BOX 7009
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:HI
Mailing Address - Zip Code:96737-7009
Mailing Address - Country:US
Mailing Address - Phone:808-929-9425
Mailing Address - Fax:808-929-9440
Practice Address - Street 1:92-1471 ALOHA BLVD
Practice Address - Street 2:
Practice Address - City:OCEAN VIEW
Practice Address - State:HI
Practice Address - Zip Code:96737-7063
Practice Address - Country:US
Practice Address - Phone:808-929-9425
Practice Address - Fax:808-929-9440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN756363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH101492Medicare PIN