Healthcare Provider Details

I. General information

NPI: 1336310960
Provider Name (Legal Business Name): TAYLOR ANN HAMIL LM, CPM, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2008
Last Update Date: 04/09/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74-5577 PALANI RD UNIT 3645
KAILUA KONA HI
96745-7166
US

IV. Provider business mailing address

PO BOX 3645
KAILUA KONA HI
96745-3645
US

V. Phone/Fax

Practice location:
  • Phone: 206-861-5009
  • Fax:
Mailing address:
  • Phone: 206-861-5009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberLM315
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW60262585
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00019760
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License NumberMW17
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: