Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | A85063 | CA |
N | 207X00000X | Orthopaedic Surgeon | MD-14771 | HI |
Y | 207XS0106X | Orthopaedic Hand Surgeon | MD-14771 | HI |
NPI | 1063636405 |
---|---|
Provider Name | Dr. Kimberley M. I. Wirsing |
First Address | Wailuku, HI 96793-2531 |
Second Address | Wailuku, HI 96793-2531 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2007 |
Last Update Date | 17/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000278713 | HMSA BILLING NUMBER (01) | HI |
623042-02 | (05) | HI |