Healthcare Provider Details

I. General information

NPI: 1538344916
Provider Name (Legal Business Name): JANE J PELKEY RN, MPHCDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2008
Last Update Date: 01/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

952 N KING ST
HONOLULU HI
96817-4556
US

IV. Provider business mailing address

915 N KING ST
HONOLULU HI
96817-4544
US

V. Phone/Fax

Practice location:
  • Phone: 808-847-4111
  • Fax: 808-845-2413
Mailing address:
  • Phone: 808-847-4111
  • Fax: 808-845-2413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN16749
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: