Individual provider Active NPI

Denise Michele Koutrouba, NURSE PRACTITIONER

  • Women's Health Nurse Practitioner
  • Tripler AMC, HI
National Provider Identifier
1174559157
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
264283 Issued in MA
Practice address
1 Jarrett White Rd
Tripler Army Medical Center Attn: MCHK-QS
Tripler AMC, HI 96859-5001
Phone
(808) 433-2460
Fax
(808) 433-1558
NPI assigned
Jun 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology/Infertility Registered Nurse 163WR1000X 275890 CA
Women's Health Nurse Practitioner 363LW0102X 275890 CA
Women's Health Nurse Practitioner 363LW0102X 264283 MA Primary

Addresses

Primary practice location

1 Jarrett White Rd
Tripler Army Medical Center Attn: MCHK-QS
Tripler AMC, HI 96859-5001

Mailing address

Jarrett White Road
Tripler Army Medical Center Attn: MCHK-QS
Tripler AMC, HI 96859-5001
Phone (808) 433-2460

Other identifiers 3

IdentifierTypeStateIssuer
275890OtherCALICENSE
37OtherHINURSE PRACTITIONER
264283OtherMANURSE PRACTITIONER LICENS

Other names 1

  • Mrs. Denise Michele Randle Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
275890CAMDReproductive Endocrinology/Infertility Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1174559157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "JARRETT WHITE ROAD",
            "address_2": "TRIPLER ARMY MEDICAL CENTER ATTN: MCHK-QS",
            "city": "TRIPLER AMC",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "808-433-2460",
            "fax_number": "808-433-1558"
        },
        {
            "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 ATTN: MCHK-QS",
            "city": "TRIPLER AMC",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "808-433-2460",
            "fax_number": "808-433-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUTROUBA",
        "first_name": "DENISE",
        "middle_name": "MICHELE",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Reproductive Endocrinology/Infertility",
            "state": "CA",
            "license": "275890",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "275890",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "264283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "275890",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER",
            "identifier": "37",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENS",
            "identifier": "264283",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "RANDLE",
            "middle_name": "MICHELE",
            "prefix": "MRS.",
            "credential": "NURSE PRACTITIONER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tripler AMC, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.