Provider Demographics
NPI:1528807617
Name:KONA NP LLC
Entity type:Organization
Organization Name:KONA NP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:VENTENILLA
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:808-333-8418
Mailing Address - Street 1:75-661 MEA LANAKILA ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-6915
Mailing Address - Country:US
Mailing Address - Phone:808-333-8418
Mailing Address - Fax:808-731-5701
Practice Address - Street 1:75-661 MEA LANAKILA ST
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-6915
Practice Address - Country:US
Practice Address - Phone:808-333-8418
Practice Address - Fax:808-731-5701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty