Provider Demographics
NPI:1942863584
Name:SORTO, KATHERINE LYNN
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LYNN
Last Name:SORTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-450 MOKUOLA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3388
Mailing Address - Country:US
Mailing Address - Phone:808-944-2882
Mailing Address - Fax:
Practice Address - Street 1:1 MOANALUA RDG
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96818-3936
Practice Address - Country:US
Practice Address - Phone:808-305-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI19062164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse