Basic Information
Provider Information
NPI: 1295711489
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KERNS
FirstName: TAMIE
MiddleName: L.
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3288 MOANALUA RD
Address2:  
City: HONOLULU
State: HI
PostalCode: 968191469
CountryCode: US
TelephoneNumber: 8084320000
FaxNumber:  
Practice Location
Address1: 3288 MOANALUA RD
Address2:  
City: HONOLULU
State: HI
PostalCode: 968191469
CountryCode: US
TelephoneNumber: 8084320000
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/19/2005
LastUpdateDate: 05/10/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/10/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003XDOS 1144HIY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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