Provider Demographics
NPI:1326882333
Name:KANU 'IA
Entity type:Organization
Organization Name:KANU 'IA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE/LACTATION CONSULTA
Authorized Official - Prefix:
Authorized Official - First Name:FOEATA
Authorized Official - Middle Name:
Authorized Official - Last Name:BACLAYON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-366-7159
Mailing Address - Street 1:458 MANAWAI ST APT 407
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-4626
Mailing Address - Country:US
Mailing Address - Phone:808-366-7159
Mailing Address - Fax:
Practice Address - Street 1:458 MANAWAI ST APT 407
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-4626
Practice Address - Country:US
Practice Address - Phone:808-366-7159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty