Healthcare Provider Details

I. General information

NPI: 1619834728
Provider Name (Legal Business Name): KATIE N SCHISSELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 PUUHONU PL STE 104
HILO HI
96720-2060
US

IV. Provider business mailing address

275 KAUPAKALUA RD
HAIKU HI
96708-5911
US

V. Phone/Fax

Practice location:
  • Phone: 808-867-8002
  • Fax: 808-217-9174
Mailing address:
  • Phone: 808-446-1263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberAPRN-5566
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: