Kenyua N. Johnson FNP-BC, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN1560 Issued in HI

Legal business name

KENYUA N. JOHNSON FNP-BC, LLC

Practice address

1415 Victoria St Apt 205
Honolulu, HI 96822-3697

Phone

(808) 292-8028

Fax

(808) 356-0609

NPI assigned

Jul 16, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Kenyua Johnson, FNP-BC

Title

Family Nurse Practitioner

Phone

(808) 216-5179

Specialties & licenses 1

Addresses

Other names 1

• Waiola Medical Doing business as

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422230400000",
    "number": "1700293248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 VICTORIA ST APT 205",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968223697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 VICTORIA ST APT 205",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968223697",
            "telephone_number": "808-292-8028",
            "fax_number": "808-356-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENYUA N. JOHNSON FNP-BC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-16",
        "last_updated": "2015-01-26",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KENYUA",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "808-216-5179",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN1560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waiola Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Nurse Practitioner in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Family Nurse Practitioner in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; 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.