Provider Demographics
NPI:1558252783
Name:NAMOCA, MELANNIE (APRN)
Entity type:Individual
Prefix:
First Name:MELANNIE
Middle Name:
Last Name:NAMOCA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95-720 LANIKUHANA AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-2984
Mailing Address - Country:US
Mailing Address - Phone:808-762-0261
Mailing Address - Fax:
Practice Address - Street 1:95-720 LANIKUHANA AVE STE 220
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-2984
Practice Address - Country:US
Practice Address - Phone:808-762-0261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-5323363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily