Healthcare Provider Details

I. General information

NPI: 1518662451
Provider Name (Legal Business Name): JULIE KATHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2023
Last Update Date: 04/10/2023
Certification Date: 04/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PUNCHBOWL ST
HONOLULU HI
96813-2499
US

IV. Provider business mailing address

1301 PUNCHBOWL ST
HONOLULU HI
96813-2499
US

V. Phone/Fax

Practice location:
  • Phone: 808-691-4454
  • Fax:
Mailing address:
  • Phone: 808-691-4454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SN0000X
TaxonomyNeonatal Clinical Nurse Specialist
License NumberAPRN-2767
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License NumberAPRN-2767
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code364SP1700X
TaxonomyPerinatal Clinical Nurse Specialist
License NumberAPRN-2767
License Number StateHI
# 4
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberAPRN-2767
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: