Provider Demographics
NPI:1912962077
Name:HAHN, JACQUELINE NMI (ND)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:NMI
Last Name:HAHN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:JACQUI
Other - Middle Name:NMI
Other - Last Name:HAHN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ND
Mailing Address - Street 1:142 KINOOLE ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2838
Mailing Address - Country:US
Mailing Address - Phone:808-969-7848
Mailing Address - Fax:
Practice Address - Street 1:142 KINOOLE ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2838
Practice Address - Country:US
Practice Address - Phone:808-969-7848
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIND120175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath