Provider Demographics
NPI:1427614809
Name:KERN, SHIRLEY IRENE (LPN)
Entity type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:IRENE
Last Name:KERN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 N KING ST APT A323
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-5714
Mailing Address - Country:US
Mailing Address - Phone:808-777-9376
Mailing Address - Fax:
Practice Address - Street 1:607 N KING ST APT A323
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-5714
Practice Address - Country:US
Practice Address - Phone:808-777-9376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-11
Last Update Date:2019-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI6573164W00000X, 164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse