Provider Demographics
NPI:1639723828
Name:FRONTELLI, KATHERINE MAE (RN)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MAE
Last Name:FRONTELLI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:M
Other - Last Name:FRONTELLI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:12-4930 UPPER-PUNA RD
Mailing Address - Street 2:
Mailing Address - City:PAHOA
Mailing Address - State:HI
Mailing Address - Zip Code:96778
Mailing Address - Country:US
Mailing Address - Phone:808-747-3157
Mailing Address - Fax:
Practice Address - Street 1:12-4930 UPPER-PUNA RD
Practice Address - Street 2:
Practice Address - City:PAHOA
Practice Address - State:HI
Practice Address - Zip Code:96778-9677
Practice Address - Country:US
Practice Address - Phone:808-747-3157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-26
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN-72448163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse