| Healing Tides Primary Care Llc | |
|
1110 Nuuanu Ave # A1-182 Honolulu HI 96817-5119 | |
| (808) 271-2619 | |
| Not Available |
| Full Name | Healing Tides Primary Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1110 Nuuanu Ave # A1-182, Honolulu, Hawaii |
| Authorized Official Name and Position | Erin Hunt (OWNER) |
| Authorized Official Contact | 8082712619 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healing Tides Primary Care Llc 1110 Nuuanu Ave # A1-182 Honolulu HI 96817-5119 Ph: (808) 271-2619 | Healing Tides Primary Care Llc 1110 Nuuanu Ave # A1-182 Honolulu HI 96817-5119 Ph: (808) 271-2619 |
| NPI Number | 1225657307 |
|---|---|
| Provider Enumeration Date | 04/09/2020 |
| Last Update Date | 04/14/2020 |
| Medicare PECOS PAC ID | 2466883913 |
|---|---|
| Medicare Enrollment ID | O20200515002423 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225657307 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kelly L Milot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366777138 PECOS PAC ID: 3072808039 Enrollment ID: I20160830001188 |
| Provider Name | Erin L Hunt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639514573 PECOS PAC ID: 7911220504 Enrollment ID: I20161201001289 |
| Provider Name | Shauna M Raboteau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679979025 PECOS PAC ID: 4183934680 Enrollment ID: I20181207002339 |
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