Healthcare Provider Details

I. General information

NPI: 1487974820
Provider Name (Legal Business Name): KAREN LYNN FERGUSON-RANIS LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2010
Last Update Date: 06/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2-2488 KAUMUALII HWY
KALAHEO HI
96741-8311
US

IV. Provider business mailing address

2-2488 KAUMUALII HWY
KALAHEO HI
96741-8311
US

V. Phone/Fax

Practice location:
  • Phone: 808-332-5580
  • Fax: 808-332-5581
Mailing address:
  • Phone: 808-332-5580
  • Fax: 808-332-5581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number8309
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: