1831016641 NPI number — KIMI-ANNE NISHIHARA OTD

Table of content: RACHEL L HURLBURT (NPI 1336715036)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831016641 NPI number — KIMI-ANNE NISHIHARA OTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NISHIHARA
Provider First Name:
KIMI-ANNE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
OTD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ANDERSHOCK
Provider Other First Name:
KIMI
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
OTD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1831016641
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/02/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1319 PUNAHOU ST
Provider Second Line Business Mailing Address:
DHT FL3 REHABILITATION
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96826
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-983-8235
Provider Business Mailing Address Fax Number:
808-983-6752

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1319 PUNAHOU 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:
96826-1028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-983-8235
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/01/2026

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: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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