Provider Demographics
NPI:1386044998
Name:CALLAWAY, JANET
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:CALLAWAY
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 1:67-5011 YUTAKA PEN PL
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-8379
Mailing Address - Country:US
Mailing Address - Phone:808-333-5218
Mailing Address - Fax:
Practice Address - Street 1:67-5011 YUTAKA PEN PL
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8379
Practice Address - Country:US
Practice Address - Phone:808-333-5218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education