Provider Demographics
NPI:1679672141
Name:KATT, KATHLEEN H (MD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:H
Last Name:KATT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:HARRIS
Other - Last Name:BRATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:407 ULUNIU ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2519
Mailing Address - Country:US
Mailing Address - Phone:808-261-3326
Mailing Address - Fax:808-263-4604
Practice Address - Street 1:407 ULUNIU ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2519
Practice Address - Country:US
Practice Address - Phone:808-261-3326
Practice Address - Fax:808-263-4604
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-13575207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000256107OtherHMSA
HI573065Medicaid
HI0000256107OtherHMSA