Provider Demographics
NPI:1871195271
Name:NIKAIDO, LINDSEY YA
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:YA
Last Name:NIKAIDO
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 1:94-595 KUPUOHI ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-5382
Mailing Address - Country:US
Mailing Address - Phone:808-688-9096
Mailing Address - Fax:808-688-9100
Practice Address - Street 1:94-595 KUPUOHI ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-5382
Practice Address - Country:US
Practice Address - Phone:808-688-9096
Practice Address - Fax:808-688-9100
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-3216183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist