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NPI Code Detail

MEDICARE: MRS. DIANE NOELANI KIILEHUA NP

MEDICARE: MRS. DIANE NOELANI KIILEHUA NP
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
1163W00000XRegistered Nurse50730HI
2363LF0000XFamily Nurse PractitionerCA95000149CA

General Provider Information

NPI Number : 1578559571
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DIANE NOELANI KIILEHUA NP
Provider Business Mailing Address
First Line : 1609 ALOHA AVE
Second Line :
City : PEARL CITY
State : HI
Zip : 96782-3431
Country : US
Telephone Number : 808-741-6679
Fax Number :
Provider Business Practice Location Address
First Line : 937 FRANKLIN BLVD
Second Line :
City : LEMOORE
State : CA
Zip : 93246-4908
Country : US
Telephone Number : 559-998-4712
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2005
Last Update Date : 09/14/2018

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