Provider Demographics
NPI:1780926030
Name:LUEKER-WALLACE, ANNA-LENA (MD)
Entity type:Individual
Prefix:
First Name:ANNA-LENA
Middle Name:
Last Name:LUEKER-WALLACE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNA-LENA
Other - Middle Name:
Other - Last Name:LUEKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1681 MAHANI LOOP
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819
Mailing Address - Country:US
Mailing Address - Phone:808-394-7321
Mailing Address - Fax:
Practice Address - Street 1:KAPIOLANI MEDICAL CENTER FOR WOMEN AND CHILDREN
Practice Address - Street 2:1319 PUNAHOU ST, 2ND FLOOR
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826
Practice Address - Country:US
Practice Address - Phone:808-394-7321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI18596208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
6487OtherMDR