Provider Demographics
NPI:1659551307
Name:NOGUCHI, KELLIE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:KELLIE
Middle Name:
Last Name:NOGUCHI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KELLE
Other - Middle Name:
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:501 ALAKAWA ST STE 101
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-5700
Mailing Address - Country:US
Mailing Address - Phone:808-432-5500
Mailing Address - Fax:
Practice Address - Street 1:501 ALAKAWA ST STE 101
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-5700
Practice Address - Country:US
Practice Address - Phone:808-432-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-10
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-2696183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist