Provider Demographics
NPI:1730968314
Name:OHTA, ALLISON MIEKO (APRN)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:MIEKO
Last Name:OHTA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:MIEKO
Other - Last Name:SAKODA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:615 PONAHAWAI ST STE 201
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-7665
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:615 PONAHAWAI ST STE 201
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-7665
Practice Address - Country:US
Practice Address - Phone:808-935-1621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-4239363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily