Provider Demographics
NPI:1013672435
Name:LAIKUPU, KEOHIKAI MICHAEL (NP)
Entity Type:Individual
Prefix:
First Name:KEOHIKAI
Middle Name:MICHAEL
Last Name:LAIKUPU
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 492412
Mailing Address - Street 2:
Mailing Address - City:KEAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96749-2412
Mailing Address - Country:US
Mailing Address - Phone:808-634-7231
Mailing Address - Fax:
Practice Address - Street 1:15-1370 25TH AVE.
Practice Address - Street 2:
Practice Address - City:KEAAU
Practice Address - State:HI
Practice Address - Zip Code:96749-9674
Practice Address - Country:US
Practice Address - Phone:808-634-7231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-01
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-3369363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care