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NPI 1043972953

IndividualActive

Bonny Anne Wallace

NPI 1043972953 · Community Health Worker · Hilo, HI

Provider details

NPI number: 1043972953
Entity type: Individual
Primary specialty: Community Health WorkerOther Service Providers
Sex: Female
Sole proprietor: No

Practice location

167 Aipuni St

Hilo, HI 96720-1803

Phone: (808) 959-5855

More HI providers

Mailing address

1786 Kinoole St

Hilo, HI 96720-5245

Registry dates

Enumerated: 2021-10-07
Last updated: 2021-10-07

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Bonny Anne Wallace — NPI 1043972953, Hilo, HI | NPI Central