Provider Demographics
NPI:1144950452
Name:LIM, SHANNON AURORA KU'UIPO (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:AURORA KU'UIPO
Last Name:LIM
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-1005 MOANALUA RD SPC 4030
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4734
Mailing Address - Country:US
Mailing Address - Phone:808-485-3037
Mailing Address - Fax:
Practice Address - Street 1:98-1005 MOANALUA RD SPC 4030
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4734
Practice Address - Country:US
Practice Address - Phone:808-485-3037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-10
Last Update Date:2024-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-3467363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner