1447450036 NPI number — MS. KATHLEEN ANN BRENNAN APRN-RX, FNP

Table of content: MS. KATHLEEN ANN BRENNAN APRN-RX, FNP (NPI 1447450036)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447450036 NPI number — MS. KATHLEEN ANN BRENNAN APRN-RX, FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRENNAN
Provider First Name:
KATHLEEN
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
APRN-RX, FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BRENNAN
Provider Other First Name:
KATHLEEN
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447450036
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/03/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2239 N SCHOOL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96819-2539
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-791-9400
Provider Business Mailing Address Fax Number:
808-847-6051

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2239 N SCHOOL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96819-2539
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-791-9400
Provider Business Practice Location Address Fax Number:
808-847-6051
Provider Enumeration Date:
07/20/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  APRN 463, RX 111 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 001030-6 . This is a "HMSA-2" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 12-1800 . This is a "MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000992101 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".