1235788738 NPI number — ALEXIS ELIZABETH GRIEVES DNP, APRN, PMHNP-BC

Table of content: ALEXIS ELIZABETH GRIEVES DNP, APRN, PMHNP-BC (NPI 1235788738)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235788738 NPI number — ALEXIS ELIZABETH GRIEVES DNP, APRN, PMHNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRIEVES
Provider First Name:
ALEXIS
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DNP, APRN, PMHNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GOOD
Provider Other First Name:
ALEXIS
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN, BSN, PMH-BC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1235788738
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2239 N SCHOOL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96819-2539
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2239 N SCHOOL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96819-5605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-791-9400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/06/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  R-236938-3 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: APRN-3734-0 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: RN-107616-0 . This is a "HAWAII BOARD OF NURSING - RN LICENSE" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 263352 . This is a "WISCONSIN BOARD OF NURSING - RN LICENSE" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: APRN-3734-0 . This is a "HAWAII BOARD OF NURSING - APRN LICENSE" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: R-236938-3 . This is a "MINNESOTA BOARD OF NURSING" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 9862 . This is a "MINNESOTA BOARD OF NURSING - APRN LICENSE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".