Provider Demographics
NPI:1871261529
Name:LE, BETH G (APRN)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:G
Last Name:LE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 MERCHANT ST STE 2900
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4384
Mailing Address - Country:US
Mailing Address - Phone:808-927-9678
Mailing Address - Fax:
Practice Address - Street 1:55 MERCHANT ST STE 2900
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4384
Practice Address - Country:US
Practice Address - Phone:808-536-8012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11014940363L00000X
HIAPRN3062363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner