Organization Active NPI

Tranquil Shores Mental Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Hilo, HI
National Provider Identifier
1790672277
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
TRANQUIL SHORES MENTAL WELLNESS LLC
Practice address
120 Keawe St # 203B
Hilo, HI 96720-2874
Phone
(808) 400-6315
Fax
(808) 480-8344
NPI assigned
Jun 18, 2025
Last updated
Jun 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Authorized official

Name
Nicole Ervin, APRNNPI 1881033439
Title
Owner
Phone
(808) 400-6315

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X Primary

Addresses

Primary practice location

120 Keawe St # 203B
Hilo, HI 96720-2874

Mailing address

PO Box 554
Hilo, HI 96721-0554

National Provider Directory

National Provider Directory

Locations

120 Keawe St
#203B
Hilo, HI 96720
Phone (808) 400-6315

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1750204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750204800000",
    "number": "1790672277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 554",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967210554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 KEAWE ST # 203B",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202874",
            "telephone_number": "808-400-6315",
            "fax_number": "808-480-8344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANQUIL SHORES MENTAL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-18",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A",
        "authorized_official_last_name": "ERVIN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-400-6315",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; 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.