Provider Demographics
NPI:1447375266
Name:RICHMOND, ERIC B (CRNA)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:B
Last Name:RICHMOND
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-715 IHO PL
Mailing Address - Street 2:BUILDING 4 APT 1501
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-2514
Mailing Address - Country:US
Mailing Address - Phone:808-484-0608
Mailing Address - Fax:
Practice Address - Street 1:1319 PUNAHOU ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1001
Practice Address - Country:US
Practice Address - Phone:808-986-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN786367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered