| NPI | 1992696819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY MARIE PIVONKA Nurse Practitioner 808-429-9795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-07-10 |
| Last Update Date | 2025-07-10 |