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General NPI Number Information
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NPI Number | 1912752254
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Entity Type | Individual
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Provider Name | KELLI KOBASHIGAWA
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Gender | Female
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Dates
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Enumeration Date | 04/19/2024
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Last Update Date | 04/19/2024
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Provider Practice Location Address
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Address Line | 91-1097 KAI OIO ST
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City | EWA BEACH
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State | HI
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Zip | 96706-6279
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Country | US
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Telephone | 808-433-5195
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Fax |
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Provider Business Mailing Address
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Address Line | 459 PATTERSON RD
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City | HONOLULU
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State | HI
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Zip | 96819-1522
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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 | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | RN-43653
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License Number State | HI
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