Provider Demographics
NPI:1699101782
Name:HALDIMAN, KATHRYN (RN)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:HALDIMAN
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 1:222 LANILOA WAY
Mailing Address - Street 2:
Mailing Address - City:HAIKU
Mailing Address - State:HI
Mailing Address - Zip Code:96708-5381
Mailing Address - Country:US
Mailing Address - Phone:808-446-9804
Mailing Address - Fax:
Practice Address - Street 1:222 LANILOA WAY
Practice Address - Street 2:
Practice Address - City:HAIKU
Practice Address - State:HI
Practice Address - Zip Code:96708-5381
Practice Address - Country:US
Practice Address - Phone:808-446-9804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-20
Last Update Date:2025-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X
HIRN-86228163WN1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support