MS. DENISE MICHELE KOUTROUBA (NPI# 1174559157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174559157 |
Entity Type | Individual |
Full Name | MS. DENISE MICHELE KOUTROUBA |
Other Name | MRS. DENISE MICHELE RANDLE |
Credential | NURSE PRACTITIONER |
Practice Address |
1 Jarrett White Rd Tripler Army Medical Center Attn: Mchk-qs Tripler Amc HI 96859-5001 |
Mailing Address |
Jarrett White Road Tripler Army Medical Center Attn: Mchk-qs Tripler Amc HI 96859-5001 |
Practice Telephone | 8084332460 |
Practice Fax Number | 8084331558 |
Mailing Telephone | 8084332460 |
Mailing Fax Number | 8084331558 |
Enumeration Date | 2006-06-23 |
Last Update Date | 2007-07-09 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
X | 163WR1000X |
Registered Nurse Specialization: Reproductive Endocrinology/Infertility |
275890 | CA | Nursing Service Providers |
X | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
264283 | MA | Physician Assistants & Advanced Practice Nursing Providers |
X | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
275890 | CA | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
HI | NURSE PRACTITIONER | 37 | 01 |
CA | LICENSE | 275890 | 01 |
MA | NURSE PRACTITIONER LICENS | 264283 | 01 |
Street Address |
1 JARRETT WHITE RD TRIPLER ARMY MEDICAL CENTER ATTN: MCHK-QS |
City | TRIPLER AMC |
State | HI |
Zip Code | 96859-5001 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013515352 | Erin M Kang | Military Health Care Provider | 1 Jarrett White Rd, Tripler Amc, HI 96859-5001 | 2020-10-09 |
1477199149 | Thomas Petersen | Physical Therapist | 1 Jarrett White Rd, Tripler Amc, HI 96859-5001 | 2019-11-18 |
1285277962 | Emily Floyd Simpson | Nurse Practitioner | 1 Jarrett White Rd, Tripler Amc, HI 96859-5001 | 2019-10-24 |
1659931731 | Melissa Nycole Work | Audiologist | 1 Jarrett White Rd, Tripler Amc, HI 96859-5001 | 2019-06-19 |
1366000887 | Andrea Moon | Student in an Organized Health Care Education/Training Program | 1 Jarrett White Rd, Tripler Amc, HI 96859-5001 | 2019-05-30 |
1316500242 | Kaitlin Dresser | Dietitian, Registered | 1 Jarrett White Rd, Tripler Amc, HI 96859-5001 | 2019-04-16 |
1366925414 | Quoc Tuan Minh Luong | Licensed Vocational Nurse | 1 Jarrett White Rd, Tripler Amc, HI 96859-5001 | 2018-09-13 |
1487131249 | Alexander Junho Song | Dentist | 1 Jarrett White Rd, Tripler Amc, HI 96859-5001 | 2018-07-25 |
1922591304 | Hannah Russin | Student in an Organized Health Care Education/Training Program | 1 Jarrett White Rd, Tripler Amc, HI 96859-5001 | 2018-06-11 |
1184116592 | Adam Kisling | Internal Medicine | 1 Jarrett White Rd, Tripler Amc, HI 96859-5001 | 2018-05-31 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770115792 | The Janz Corporation | Durable Medical Equipment & Medical Supplies | Tripler Medical Center, C-103, Honolulu, HI 96859 | 2020-02-07 |
1467726927 | Elton E Bacon | Orthotist | 1 Jarrett White Rd Dept of The Army, Attn: Orthopedic Brace Clinic (mchk-dso-a), Tripler Amc, HI 96859 | 2012-03-01 |
1063738813 | Defense Finance & Actg Service | Military Hospital | 691 Schofield Barracks, U.s Army Health Clinic Bldg, Wahiawa, HI 96859 | 2010-04-19 |
1972737153 | Kyong Su Min | Orthopaedic Surgery | 1 Jarrett White Rd Bldg 4f, Tripler Army Medical Center, HI 96859 | 2009-05-04 |
1558503854 | Mark Andrew Gerum | Social Worker | Tripler Army Medical Center, 1 Jarrett White Road, Intensive Outpatient Program (iop), Honolulu, HI 96859 | 2009-04-01 |
1578720926 | Travis Jaya Mason | Surgery | Tripler Army Medical Center 1 Jarrett White Road, Honolulu, HI 96859 | 2008-05-21 |
1467513168 | Joselyn Cabalo Funtanilla Ponce | Registered Nurse | 1 Jarrett White Rd Bldg 4, Tripler Amc, HI 96859 | 2006-12-13 |
1346280195 | Harkirtin Kaur Mciver | Pediatrics | Tripler Army Medical Center Mchk-pe, 1 Jarrett White Road, Honolulu, HI 96859 | 2006-06-08 |
1043297740 | Jacqueline Seger | Registered Nurse | Tamc 1 Jarrett-white Rd., 1 Jarrett-white Rd. / Mchk-dsc, Honolulu, HI 96859 | 2005-12-23 |
1982694683 | Peter Marlin | Psychiatry & Neurology | Tamc, 1 Jarriet White Road, Honolulu, HI 96859 | 2005-10-24 |
Find all providers in zip 96859 |
Taxonomy Code | 163WR1000X |
Grouping | Nursing Service Providers |
Classification | Registered Nurse |
Specialization | Reproductive Endocrinology/Infertility |
Definition to come... |
City | TRIPLER AMC |
Zip Code | 96859 |
Please comment or provide details below to improve the information on MS. DENISE MICHELE KOUTROUBA.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.