| Park Wellness | |
|
16-590 Old Volcano Rd Ste B Keaau HI 96749-8158 | |
| (808) 333-3450 | |
| (808) 930-4721 |
| Full Name | Park Wellness |
|---|---|
| Speciality | Clinic/Center |
| Location | 16-590 Old Volcano Rd Ste B, Keaau, Hawaii |
| Authorized Official Name and Position | Jennifer Grune (CEO/APRN) |
| Authorized Official Contact | 8083333450 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Wellness 16-590 Old Volcano Rd Ste B Keaau HI 96749-8158 Ph: (808) 333-3450 | Park Wellness 16-590 Old Volcano Rd Ste B Keaau HI 96749-8158 Ph: (808) 333-3450 |
| NPI Number | 1861994626 |
|---|---|
| Provider Enumeration Date | 03/07/2018 |
| Last Update Date | 09/04/2024 |
| Medicare PECOS PAC ID | 5294098042 |
|---|---|
| Medicare Enrollment ID | O20180410001032 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861994626 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | APRN-2244 (Hawaii) | Secondary |
| Provider Name | Jennifer K Grune |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720599640 PECOS PAC ID: 3072873421 Enrollment ID: I20180305001899 |
| Provider Name | Lorna Magaoay Linville |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871063982 PECOS PAC ID: 1759794357 Enrollment ID: I20201228001236 |
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