Provider Demographics
NPI:1528487121
Name:KUO, BRADLEY JOHN (FNP-BC, PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:JOHN
Last Name:KUO
Suffix:
Gender:M
Credentials:FNP-BC, PMHNP-BC
Other - Prefix:MR
Other - First Name:BRADLEY
Other - Middle Name:JOHN
Other - Last Name:KANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1188 BISHOP ST STE 2602
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3310
Mailing Address - Country:US
Mailing Address - Phone:808-379-6656
Mailing Address - Fax:844-456-1151
Practice Address - Street 1:1188 BISHOP ST STE 2602
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3310
Practice Address - Country:US
Practice Address - Phone:808-379-6656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1741363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily