Provider Demographics
NPI:1801123955
Name:KI'ILI, SERINA HALEAKA KANEAUMOANA (CD(BFDA))
Entity type:Individual
Prefix:
First Name:SERINA
Middle Name:HALEAKA KANEAUMOANA
Last Name:KI'ILI
Suffix:
Gender:F
Credentials:CD(BFDA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5831
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-8831
Mailing Address - Country:US
Mailing Address - Phone:808-756-5946
Mailing Address - Fax:
Practice Address - Street 1:11-3183 MOKUNA ST
Practice Address - Street 2:
Practice Address - City:VOLCANO
Practice Address - State:HI
Practice Address - Zip Code:96785
Practice Address - Country:US
Practice Address - Phone:808-756-5946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula