Provider Demographics
NPI:1477356939
Name:PHEM, ANKEARATH
Entity type:Individual
Prefix:
First Name:ANKEARATH
Middle Name:
Last Name:PHEM
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 1:73-1245 MELOMELO ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-8504
Mailing Address - Country:US
Mailing Address - Phone:808-365-4453
Mailing Address - Fax:
Practice Address - Street 1:73-1245 MELOMELO ST
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-8504
Practice Address - Country:US
Practice Address - Phone:808-315-1522
Practice Address - Fax:
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
HI104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker