Individual provider Active NPI

Kristine Marie Yearwood, DNP-FNP

  • Family Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1114016185
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
07731 Issued in OH
Practice address
1 Jarrett White Rd
Tripler Army Medical Center
Honolulu, HI 96859
Phone
(808) 433-2155
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 735063 TX
Family Nurse Practitioner 363LF0000X 1611 HI
Family Nurse Practitioner 363LF0000X 07731 OH Primary

Addresses

Primary practice location

1 Jarrett White Rd
Tripler Army Medical Center
Honolulu, HI 96859

Mailing address

1601 Harmon Ave
Fort Stewart, GA 31314-5641
Phone (912) 435-6965

Other names 1

  • Kristine Marie Varga Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241021001173 AL Order and Referring Only - Nurse Practitioner 6406388032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1611HIMDChiropractor
07731OHMDFamily Nurse Practitioner
735063TXMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1114016185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 HARMON AVE",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-435-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "address_2": "TRIPLER ARMY MEDICAL CENTER",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96859",
            "telephone_number": "808-433-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEARWOOD",
        "first_name": "KRISTINE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "DNP-FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "735063",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "1611",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "07731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "VARGA",
            "middle_name": "MARIE",
            "credential": "DNP-FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.