Provider Demographics
NPI:1659196368
Name:KIYUNA, ALYSE RENEE (NP)
Entity type:Individual
Prefix:MRS
First Name:ALYSE
Middle Name:RENEE
Last Name:KIYUNA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 HAOA ST APT 211
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-2132
Mailing Address - Country:US
Mailing Address - Phone:832-647-9245
Mailing Address - Fax:
Practice Address - Street 1:4319 HARDY ST
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1252
Practice Address - Country:US
Practice Address - Phone:808-274-3150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-4814207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine