Mona S Brack, R.N., CDE

Individual provider Active NPI Diabetes Educator Registered Nurse · Honolulu, HI

NPI 1720142862 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1720142862
Entity type
Individual (NPI type 1)
Primary specialty
Diabetes Educator Registered Nurse 163WD0400X
License
RN 34498 (HI)
Practice address
1301 Punchbowl St
Honolulu, HI 96813-2402
Phone
(808) 547-4823
Fax
(808) 585-5399
NPI assigned
Dec 21, 2006
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN 34498HIMDDiabetes Educator Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X RN 34498 HI Yes

Addresses

Primary practice location

1301 Punchbowl St
Honolulu, HI 96813-2402

Mailing address

1301 Punchbowl St
Honolulu, HI 96813-2402
Phone (808) 547-4823

Other identifiers

IdentifierTypeStateIssuer
0000260828OtherHIHMSA PROVIDER NUMBER

Other providers in Honolulu, HI

All providers in Honolulu, HI · Diabetes Educator Registered Nurse in Hawaii

Sources for this page

Verify at the official NPI Registry.