Alysha Delphine Enbom, is a
Nurse Practitioner - Family based in Hanapepe, Hawaii. Alysha Delphine Enbom is licensed to practice in Hawaii (license number APRN-4642) and her current practice location is
Po Box 624, Hanapepe, Hawaii. She can be reached at her office (for appointments etc.) via phone at
(360) 301-5568.
NPI number for Alysha Delphine Enbom is 1457100299 and her current mailing address is Po Box 624, Hanapepe, Hawaii. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1457100299.
Provider's Profile
| Full Name | Alysha Delphine Enbom |
|---|
| Gender | Female |
|---|
| Speciality | Nurse Practitioner - Family |
|---|
| Location | Po Box 624, Hanapepe, Hawaii |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1457100299
- Provider Enumeration Date: 05/15/2024
- Last Update Date: 06/26/2024
Medical Identifiers
Medical identifiers for Alysha Delphine Enbom such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1457100299 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163W00000X | Registered Nurse | 55667 (Idaho) | Secondary |
| 163W00000X | Registered Nurse | RN61092439 (Washington) | Secondary |
| 163W00000X | Registered Nurse | 103027 (Hawaii) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | APRN-4642 (Hawaii) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Alysha Delphine Enbom is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Alysha Delphine Enbom,
Po Box 624,
Hanapepe, HI 96716-0624
Ph: (360) 301-5568 | Alysha Delphine Enbom,
Po Box 624,
Hanapepe, HI 96716-0624
Ph: (360) 301-5568 |
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