Healthcare Provider Details

I. General information

NPI: 1184454001
Provider Name (Legal Business Name): KYMBERLY DAWN JAMES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2024
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 SCOTT CIR BLDG 559
JBPHH HI
96853-5399
US

IV. Provider business mailing address

755 SCOTT CIR BLDG 559
JBPHH HI
96853-5399
US

V. Phone/Fax

Practice location:
  • Phone: 808-927-1481
  • Fax: 808-448-6355
Mailing address:
  • Phone: 808-927-1481
  • Fax: 808-448-6355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN-44887
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: