Provider Demographics
NPI:1316546716
Name:HUA, CODY D (DNP)
Entity type:Individual
Prefix:
First Name:CODY
Middle Name:D
Last Name:HUA
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 S BERETANIA ST STE C210A-1
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2208
Mailing Address - Country:US
Mailing Address - Phone:808-772-4995
Mailing Address - Fax:833-596-1601
Practice Address - Street 1:50 S BERETANIA ST STE C210A-1
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2208
Practice Address - Country:US
Practice Address - Phone:808-772-4995
Practice Address - Fax:833-596-1601
Is Sole Proprietor?:No
Enumeration Date:2020-10-19
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-2890363LF0000X
HIRN-85614163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse