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General NPI Number Information
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NPI Number | 1043664535
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Entity Type | Individual
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Provider Name | CHELSEY KEOLA PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/20/2016
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 1585 KAPIOLANI BLVD
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City | HONOLULU
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State | HI
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Zip | 96814-4522
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Country | US
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Telephone | 808-545-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 S BERETANIA ST STE 250
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City | HONOLULU
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State | HI
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Zip | 96814-1876
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 025905
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | AMD698
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License Number State | HI
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