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NPI Code Detail

MEDICARE: KELSEY JENNIFER PUANANI MILLS

MEDICARE: KELSEY JENNIFER PUANANI MILLS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1063155398
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY JENNIFER PUANANI MILLS
Provider Business Mailing Address
First Line : 958 PROSPECT ST
Second Line :
City : HONOLULU
State : HI
Zip : 96822-3418
Country : US
Telephone Number : 808-495-1505
Fax Number :
Provider Business Practice Location Address
First Line : 420 WAIAKAMILO RD STE 300B
Second Line :
City : HONOLULU
State : HI
Zip : 96817-4950
Country : US
Telephone Number : 808-832-5300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2022
Last Update Date : 10/03/2022

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Directions to “ KELSEY JENNIFER PUANANI MILLS ” Practice Location

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