Provider Demographics
NPI:1154966695
Name:KO, WHITNEY (RN)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:KO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2952 EUGENE PL
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1707
Mailing Address - Country:US
Mailing Address - Phone:808-799-0252
Mailing Address - Fax:
Practice Address - Street 1:2952 EUGENE PL
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-1707
Practice Address - Country:US
Practice Address - Phone:808-799-0252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN-95640163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse