Provider Demographics
NPI:1659135705
Name:LANTRY, KAYLA (LPN)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:LANTRY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3375 KOAPAKA ST STE H435
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-1870
Mailing Address - Country:US
Mailing Address - Phone:808-832-8232
Mailing Address - Fax:
Practice Address - Street 1:3375 KOAPAKA ST STE H435
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-1870
Practice Address - Country:US
Practice Address - Phone:808-832-8232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILPN-16980164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse