Healthcare Provider Details

I. General information

NPI: 1609958149
Provider Name (Legal Business Name): JANINE KATINS DELACOURT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANINE KATINS PA-C

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 02/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 LUSITANA STREET SUITE 1012
HONOLULU HI
96813-2461
US

IV. Provider business mailing address

1380 LUSITANA STREET SUITE 1012
HONOLULU HI
96813-2461
US

V. Phone/Fax

Practice location:
  • Phone: 808-546-5000
  • Fax: 808-523-1992
Mailing address:
  • Phone: 808-546-5000
  • Fax: 808-523-1992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberAMD-370
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: