Michelle L Shanks, ARNP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

1452 Issued in HI

Practice address

1005 Keolu Dr Ste a
Kailua, HI 96734-3873

Phone

(808) 727-1715

NPI assigned

Aug 26, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1245463116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84-740 KILI DR APT 427",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967921512",
            "telephone_number": "808-825-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 KEOLU DR STE A",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967343873",
            "telephone_number": "808-727-1715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51-431 Hiwahiwa St",
            "address_purpose": "LOCATION",
            "city": "Kaaawa",
            "state": "HI",
            "postal_code": "96730",
            "country_code": "US",
            "telephone_number": "502-821-9304",
            "fax_number": "808-744-6024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANKS",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "ARNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-26",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KY",
            "license": "6147",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "HI",
            "license": "1452",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "HI",
            "license": "71639",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serena Trehern
• Lauren Sergent, L.M.T.
• Victoria Serra
• Alexandra Serrano Hernandez
• Farid Brian Shaikh, D.M.D.
• Larry Jay Shapiro, MD
• Venesh Sharma, N.D.
• Carla Sharp, A.P.R.N.
• Corrine Sharp, LAC
• Sarah Shaw, COTA

• Adult Health Nurse Practitioner in Kailua, HI
• Providers in Kailua, HI by specialty
• Adult Health Nurse Practitioner in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.