Provider Demographics
NPI:1841016383
Name:MALASIG, LORI LYNN
Entity type:Individual
Prefix:
First Name:LORI LYNN
Middle Name:
Last Name:MALASIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-1238 KAAHUMANU ST STE 300
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-3250
Mailing Address - Country:US
Mailing Address - Phone:808-840-0301
Mailing Address - Fax:
Practice Address - Street 1:98-1238 KAAHUMANU ST STE 300
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-3250
Practice Address - Country:US
Practice Address - Phone:808-840-0301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-4920363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily