Provider Demographics
NPI:1336834050
Name:MEYA, KELLI ANN KIMIKO ZAKIMI (MS RD)
Entity Type:Individual
Prefix:
First Name:KELLI ANN
Middle Name:KIMIKO ZAKIMI
Last Name:MEYA
Suffix:
Gender:F
Credentials:MS RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95-1108 LOEA ST
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-6534
Mailing Address - Country:US
Mailing Address - Phone:808-232-7281
Mailing Address - Fax:
Practice Address - Street 1:95-1108 LOEA ST
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-6534
Practice Address - Country:US
Practice Address - Phone:808-232-7281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI86045091133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered