Amber Brose, LMT
Individual provider Active NPI Specialist · Kamuela, HI
NPI 1902209794 · NPPES record last updated Oct 7, 2014
Key facts
- NPI
- 1902209794
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 12011 (HI)
- Practice address
- 68 Puako Beach Dr
Kamuela, HI 96743-9707 - Phone
- (808) 557-6704
- NPI assigned
- Oct 7, 2014
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 12011 | HI | MD | Reflexologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Reflexologist | 173C00000X | 12011 | HI | |
| Specialist | 174400000X | 12011 | HI | Yes |
Addresses
Primary practice location
68 Puako Beach Dr
Kamuela, HI 96743-9707
Mailing address
PO Box 2271
Kamuela, HI 96743-2271
Phone (808) 557-6704
Other providers in Kamuela, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.