Queens.org Provider Directory: Update Your Profile

Allow 3-5 minutes to complete.

Requests to update select fields of your Physician Profile may be submitted using the form below.  Edits will be implemented once QHS staff have been able to validate the requested change via phone or email with you or your office staff.  

Any fields not listed below, including Education and Professional Credentials, are managed by Credentialing.  To request changes to those fields, please contact Credentialing directly: 

Queen’s Medical Center Credentialing: 808-691-7143
North Hawaii Community Hospital Credentialing: 808-881-4419
Molokai General Hospital Credentialing: 808-553-3127

Note: To be featured on queens.org and/or to receive referrals through the Queen's Referral Line, a physician must be in good standing with a Queen's hospital or Queen's affiliated medical group with an active, associate, provisional or senior status.

Start by Telling Us Who You Are

Who is Completing This Questionnaire?

(If you checked "I'm a Doctor", skip this section.)
If we have questions who can we email?

Provider Info

NPI will be used to validate provider information and will not be shown publicly.

Select any Abbreviated Degree(s) and Certifications that apply.

Queen's Leadership Title
(if applicable)

Are You Currently Accepting New Patients?

Practice Locations

Primary Practice Location

Practice Location 2

(If Applicable)

Practice Location 3

(If Applicable)

Queen's Referral Line

Would you like to participate in the Queen's Referral Line Directory?


Select languages available in your office.

Insurance Types Accepted

Select all insurance plans accepted at your office(s).
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