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General NPI Number Information
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NPI Number | 1659433415
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Entity Type | Individual
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Provider Name | PAMELA C MCKENNA M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 53-3925 AKONI PULE HWY
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City | KAPAAU
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State | HI
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Zip | 96755
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Country | US
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Telephone | 808-889-6236
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Fax | 808-889-0107
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Provider Business Mailing Address
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Address Line | 45-549 PLUMERIA ST
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City | HONOKAA
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State | HI
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Zip | 96727-6902
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Country | US
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Telephone | 808-775-7204
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Fax | 808-775-9404
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 54673-20
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License Number State | WI
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