Provider Demographics
NPI:1598423964
Name:FIELDS, DAVE (PMHNP)
Entity type:Individual
Prefix:MR
First Name:DAVE
Middle Name:
Last Name:FIELDS
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KAHELU AVE STE 232
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-3962
Mailing Address - Country:US
Mailing Address - Phone:818-465-8740
Mailing Address - Fax:725-215-9036
Practice Address - Street 1:100 KAHELU AVE STE 232
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-3962
Practice Address - Country:US
Practice Address - Phone:818-465-8740
Practice Address - Fax:725-215-9036
Is Sole Proprietor?:No
Enumeration Date:2021-12-02
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3456363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health