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NPI Code Detail

MEDICARE: KATHLEEN HOLSAETER DO

MEDICARE: KATHLEEN HOLSAETER DO
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
1208600000XSurgery Physician011189AZ
22086S0102XSurgical Critical Care Physician011189AZ
3208600000XSurgery PhysicianDOS-2722-0HI
42086S0102XSurgical Critical Care PhysicianDOS-2722-0HI

General Provider Information

NPI Number : 1972065084
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN HOLSAETER DO
Provider Business Mailing Address
First Line : 1494 KALANIIKI ST
Second Line :
City : HONOLULU
State : HI
Zip : 96821-1216
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6655 S CIMARRON RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2181
Country : US
Telephone Number : 702-853-3561
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2019
Last Update Date : 09/26/2025

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Directions to “ KATHLEEN HOLSAETER DO” Practice Location

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