Provider Demographics
NPI:1912273004
Name:KUTAKA, GAYLE SETSUKO (APRN)
Entity Type:Individual
Prefix:MS
First Name:GAYLE
Middle Name:SETSUKO
Last Name:KUTAKA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47-108 HUI KELU PL
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-4617
Mailing Address - Country:US
Mailing Address - Phone:808-554-7489
Mailing Address - Fax:
Practice Address - Street 1:47-108 HUI KELU PL
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-4617
Practice Address - Country:US
Practice Address - Phone:808-554-7489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-22
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN15975163WP0808X
HIAPRN 430163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health