Provider Demographics
NPI:1861039778
Name:HABERMEYER, MOLLY MONACO (FNP)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:MONACO
Last Name:HABERMEYER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:MONACO
Other - Last Name:PERRONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:335 LEWA MAWAHO LOOP
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-5947
Mailing Address - Country:US
Mailing Address - Phone:719-209-2932
Mailing Address - Fax:
Practice Address - Street 1:2176 LAUWILIWILI ST STE 1
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-1882
Practice Address - Country:US
Practice Address - Phone:808-465-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1628431163WS0200X
HIAPRN-5328363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WS0200XNursing Service ProvidersRegistered NurseSchool