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General NPI Number Information
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NPI Number | 1346033834
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Entity Type | Individual
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Provider Name | KAYLEE MCKENNA PTA
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Gender | Female
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 1401 S BERETANIA ST STE 888
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City | HONOLULU
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State | HI
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Zip | 96814-1871
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Country | US
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Telephone | 808-600-9147
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Fax |
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Provider Business Mailing Address
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Address Line | 3337 HALELANI DR
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City | HONOLULU
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State | HI
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Zip | 96822-1224
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA-770-0
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License Number State | HI
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