Provider Demographics
NPI:1841361326
Name:CARMICHAEL, RICHARD WILSON (APRN RX)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:WILSON
Last Name:CARMICHAEL
Suffix:
Gender:M
Credentials:APRN RX
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Mailing Address - Street 1:325 LANAKILA RD
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-1241
Mailing Address - Country:US
Mailing Address - Phone:808-822-0870
Mailing Address - Fax:808-245-8255
Practice Address - Street 1:3-1901 KAUMUALII HWY
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-9500
Practice Address - Country:US
Practice Address - Phone:808-245-8307
Practice Address - Fax:808-245-8298
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HIAPRN RX #24363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIA4611-8Medicare UPIN