Provider Demographics
NPI:1598877730
Name:ANACAN, CAROLYN N (LMT)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:N
Last Name:ANACAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:LANI
Other - Middle Name:
Other - Last Name:ANACAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:2751 KAPIOLANI BLVD
Mailing Address - Street 2:#402
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-4876
Mailing Address - Country:US
Mailing Address - Phone:808-291-2048
Mailing Address - Fax:
Practice Address - Street 1:1314 S KING ST
Practice Address - Street 2:#1563
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1956
Practice Address - Country:US
Practice Address - Phone:808-591-9339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3114174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist