Healthcare Provider Details

I. General information

NPI: 1811374556
Provider Name (Legal Business Name): MS. KARINA SUMMER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2015
Last Update Date: 05/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78-7047 MANA OPELU LN
HOLUALOA HI
96725-8709
US

IV. Provider business mailing address

PO BOX 788
HOLUALOA HI
96725-0788
US

V. Phone/Fax

Practice location:
  • Phone: 808-345-0335
  • Fax:
Mailing address:
  • Phone: 808-345-0335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: