Healthcare Provider Details

I. General information

NPI: 1588065734
Provider Name (Legal Business Name): AMELIA POLLARD AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMELIA KRAMER

II. Dates (important events)

Enumeration Date: 09/08/2014
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 ULUNIU ST
KAILUA HI
96734-2519
US

IV. Provider business mailing address

407 ULUNIU ST
KAILUA HI
96734-2519
US

V. Phone/Fax

Practice location:
  • Phone: 808-262-6673
  • Fax: 808-263-4368
Mailing address:
  • Phone: 808-262-6673
  • Fax: 808-263-4368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD-239-0
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number4010
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: