Nicole Matsuda, RD

Individual provider Active NPI Registered Dietitian · Lanai City, HI

NPI 1497057574 · NPPES record last updated Nov 23, 2010

Key facts

NPI
1497057574
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
00997848 (HI)
Practice address
478 Lauhala Place
Lanai Community Health Center
Lanai City, HI 96763
Phone
(808) 565-6919
NPI assigned
Nov 23, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
00997848HIMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 00997848 HI Yes

Addresses

Primary practice location

478 Lauhala Place
Lanai Community Health Center
Lanai City, HI 96763

Mailing address

1561 Pensacola St
1405
Honolulu, HI 96822-3893
Phone (808) 372-4315

Other providers in Lanai City, HI

All providers in Lanai City, HI · Registered Dietitian in Hawaii

Sources for this page

Verify at the official NPI Registry.