Provider Demographics
NPI:1154104594
Name:DUHAYLONSOD, SAMANTHA CHRISTINE HYDE (APRN)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:CHRISTINE HYDE
Last Name:DUHAYLONSOD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-3575 KAULUAKOKO ST UNIT 1504
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-5861
Mailing Address - Country:US
Mailing Address - Phone:808-741-8600
Mailing Address - Fax:
Practice Address - Street 1:66-125 KAMEHAMEHA HWY
Practice Address - Street 2:
Practice Address - City:HALEIWA
Practice Address - State:HI
Practice Address - Zip Code:96712-1601
Practice Address - Country:US
Practice Address - Phone:808-691-8501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-4196363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily