| Evolve Health Llc | |
|
1188 Bishop St Ste 1603 Honolulu HI 96813-3306 | |
| (808) 452-1731 | |
| (808) 452-1741 |
| Full Name | Evolve Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1188 Bishop St Ste 1603, Honolulu, Hawaii |
| Authorized Official Name and Position | Nicole Ryan (APRN) |
| Authorized Official Contact | 8084521731 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolve Health Llc 1188 Bishop St Ste 1603 Honolulu HI 96813-3306 Ph: (808) 452-1731 | Evolve Health Llc 1188 Bishop St Ste 1603 Honolulu HI 96813-3306 Ph: (808) 452-1731 |
| NPI Number | 1326735929 |
|---|---|
| Provider Enumeration Date | 04/24/2023 |
| Last Update Date | 08/28/2023 |
| Medicare PECOS PAC ID | 1456706605 |
|---|---|
| Medicare Enrollment ID | O20231009002560 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326735929 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Shereen L Masifi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336598184 PECOS PAC ID: 1658609334 Enrollment ID: I20210831003084 |
| Provider Name | Nicole K Ryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548931769 PECOS PAC ID: 7012391667 Enrollment ID: I20231009002691 |
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