Provider Demographics
NPI:1639847643
Name:KNUDSON WARRING, DESTINY NOELANI KB (LM, CPM)
Entity Type:Individual
Prefix:
First Name:DESTINY
Middle Name:NOELANI KB
Last Name:KNUDSON WARRING
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 663
Mailing Address - Street 2:
Mailing Address - City:HANALEI
Mailing Address - State:HI
Mailing Address - Zip Code:96714-0663
Mailing Address - Country:US
Mailing Address - Phone:808-378-9596
Mailing Address - Fax:
Practice Address - Street 1:5151 WAINIHA POWERHOUSE RD
Practice Address - Street 2:
Practice Address - City:HANALEI
Practice Address - State:HI
Practice Address - Zip Code:96714
Practice Address - Country:US
Practice Address - Phone:808-378-9596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMW-15176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife