Basic Information
| Provider Information | |||||||||
| NPI: | 1801020623 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KUALII | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1178 KINOOLE ST | ||||||||
| Address2: | |||||||||
| City: | HILO | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967207206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089343209 | ||||||||
| FaxNumber: | 8089615678 | ||||||||
| Practice Location | |||||||||
| Address1: | 224 HAILI ST | ||||||||
| Address2: | BLDG B | ||||||||
| City: | HILO | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967202975 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089343209 | ||||||||
| FaxNumber: | 8089615678 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2009 | ||||||||
| LastUpdateDate: | 05/07/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QC1500X | RN-17473 | HI | Y | Ambulatory Health Care Facilities | Clinic/Center | Community Health |
No ID Information.