Provider Demographics
NPI:1346551249
Name:KITAMURA, NATALIE S
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:S
Last Name:KITAMURA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1181
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-8181
Mailing Address - Country:US
Mailing Address - Phone:808-551-8947
Mailing Address - Fax:806-200-0935
Practice Address - Street 1:1314 S KING ST STE 624
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1941
Practice Address - Country:US
Practice Address - Phone:808-551-8947
Practice Address - Fax:860-200-0935
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-1273363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily