Provider Demographics
NPI:1578559571
Name:KIILEHUA, DIANE NOELANI (NP)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:NOELANI
Last Name:KIILEHUA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:DIANE
Other - Middle Name:NOELANI
Other - Last Name:KIILEHUA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1609 ALOHA AVE
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-3431
Mailing Address - Country:US
Mailing Address - Phone:808-741-6679
Mailing Address - Fax:
Practice Address - Street 1:937 FRANKLIN BLVD
Practice Address - Street 2:
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93246-4908
Practice Address - Country:US
Practice Address - Phone:559-998-4712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-25
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI50730163W00000X
CACA95000149363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse