1215969720 NPI number — CAROLINE KOLEY STONER N.P.C

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215969720 NPI number — CAROLINE KOLEY STONER N.P.C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KOLEY STONER
Provider First Name:
CAROLINE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
N.P.C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KOLEY
Provider Other First Name:
CAROLINE
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
APRN, NPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1215969720
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/06/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
551 LII WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAILUKU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96793-1540
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-727-0900
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
233 S MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAILUKU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96793-2218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-727-0900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/07/2006

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: 363LA2200X , with the licence number:  1671 , 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: 1671 . This is a "APRN RX LICENSE" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".




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