Provider Demographics
NPI:1720856339
Name:KAKUDA, BRETT
Entity Type:Individual
Prefix:MR
First Name:BRETT
Middle Name:
Last Name:KAKUDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7092 HAWAII KAI DR APT 30
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-3162
Mailing Address - Country:US
Mailing Address - Phone:808-226-1770
Mailing Address - Fax:
Practice Address - Street 1:7092 HAWAII KAI DR APT 30
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-3162
Practice Address - Country:US
Practice Address - Phone:808-226-1770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-4374-0363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care