Provider Demographics
NPI:1588903397
Name:BENDER, ALLYSON RAE (ARN)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:RAE
Last Name:BENDER
Suffix:
Gender:F
Credentials:ARN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2155 KALAKAUA AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-2351
Mailing Address - Country:US
Mailing Address - Phone:808-922-6739
Mailing Address - Fax:
Practice Address - Street 1:2155 KALAKAUA AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-2351
Practice Address - Country:US
Practice Address - Phone:808-922-6739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-14
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18145363LF0000X
HIAPRN-2809363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily