Healthcare Provider Details

I. General information

NPI: 1699101782
Provider Name (Legal Business Name): KATHRYN HALDIMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2013
Last Update Date: 12/07/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 LANILOA WAY
HAIKU HI
96708-5381
US

IV. Provider business mailing address

222 LANILOA WAY
HAIKU HI
96708-5381
US

V. Phone/Fax

Practice location:
  • Phone: 808-446-9804
  • Fax:
Mailing address:
  • Phone: 808-446-9804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WN1003X
TaxonomyNutrition Support Registered Nurse
License NumberRN-86228
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: