Provider Demographics
NPI:1851527238
Name:NISHIMOTO, KRISTYN MIEKO KITABAYASHI (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTYN
Middle Name:MIEKO KITABAYASHI
Last Name:NISHIMOTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTYN
Other - Middle Name:MIEKO
Other - Last Name:KITABAYASHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1319 PUNAHOU ST STE 1100
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1081
Mailing Address - Country:US
Mailing Address - Phone:808-955-7845
Mailing Address - Fax:808-946-3071
Practice Address - Street 1:1319 PUNAHOU ST STE 1100
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1081
Practice Address - Country:US
Practice Address - Phone:808-955-7845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-30
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD16622208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty