Provider Demographics
NPI:1588228142
Name:KOBYLANSKI, CHRISTY-CHARITY C (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTY-CHARITY
Middle Name:C
Last Name:KOBYLANSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:CHRISTY-CHARITY
Other - Middle Name:C
Other - Last Name:KOBYLANSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1508 KEEAUMOKU ST APT B201
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-4301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1508-B KEEAUMOKU ST APT 201
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-9682
Practice Address - Country:US
Practice Address - Phone:808-561-8655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI67360163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI67360OtherHI RN LIC