Provider Demographics
NPI:1265235725
Name:KAANAANA, PRESLYN
Entity type:Individual
Prefix:
First Name:PRESLYN
Middle Name:
Last Name:KAANAANA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 KAMEHAMEHA HWY STE 107
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-2682
Mailing Address - Country:US
Mailing Address - Phone:808-455-4555
Mailing Address - Fax:808-456-9304
Practice Address - Street 1:850 KAMEHAMEHA HWY STE 107
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-2682
Practice Address - Country:US
Practice Address - Phone:808-455-4555
Practice Address - Fax:808-456-9304
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI5124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist