Provider Demographics
NPI:1013572338
Name:KAM, KASEY KUNI (APRN-RX, AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:KUNI
Last Name:KAM
Suffix:
Gender:M
Credentials:APRN-RX, AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 KALANIANAOLE HWY STE 114A
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-1281
Mailing Address - Country:US
Mailing Address - Phone:808-888-4800
Mailing Address - Fax:
Practice Address - Street 1:6600 KALANIANAOLE HWY STE 114A
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-1281
Practice Address - Country:US
Practice Address - Phone:808-888-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI88197163W00000X
AZTELE302862363L00000X
COAPN.0999661-NP363L00000X
HIAPRN-3023363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse