Healthcare Provider Details

I. General information

NPI: 1306779277
Provider Name (Legal Business Name): KELSY BAER HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1953 S BERETANIA ST STE 3B
HONOLULU HI
96826-1340
US

IV. Provider business mailing address

PO BOX 11389
HONOLULU HI
96828-0389
US

V. Phone/Fax

Practice location:
  • Phone: 808-955-7366
  • Fax: 808-942-1938
Mailing address:
  • Phone: 808-955-7366
  • Fax: 808-942-1938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number255
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: