Provider Demographics
NPI:1871069849
Name:TRICARICO, DESIREE (MSN FNP-C)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:
Last Name:TRICARICO
Suffix:
Gender:F
Credentials:MSN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-6390 KAPOLEI PKWY, SUITE 200
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706
Mailing Address - Country:US
Mailing Address - Phone:808-691-8200
Mailing Address - Fax:808-691-3955
Practice Address - Street 1:91-6390 KAPOLEI PKWY, SUITE 200
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706
Practice Address - Country:US
Practice Address - Phone:808-691-8200
Practice Address - Fax:808-691-3955
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-2688363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner