Mind Body Nutrition RN

Primary specialty

Clinical Nurse SpecialistTaxonomy code 364S00000X

License

2154 Issued in HI

Legal business name

MIND BODY NUTRITION RN

Practice address

75-5995 Kuakini Hwy Ste 445
Kailua Kona, HI 96740-2123

Phone

(808) 315-8466

NPI assigned

Oct 18, 2016

Organization subpart

No

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

Authorized official

Name

Deborah Vance-Beaumont, APRN

Title

Owner

Phone

(415) 867-6457

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476748800000",
    "number": "1639620222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-5995 KUAKINI HWY STE 445",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402123",
            "telephone_number": "808-315-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5995 KUAKINI HWY STE 445",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402123",
            "telephone_number": "808-315-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY NUTRITION RN",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-18",
        "last_updated": "2016-10-18",
        "status": "A",
        "authorized_official_last_name": "VANCE-BEAUMONT",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-867-6457",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist",
            "state": "HI",
            "license": "2154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Nurse Specialist in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
• Clinical Nurse Specialist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; 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.