Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | DOS-1689 | HI |
NPI | 1184982613 |
---|---|
Provider Name | Katie Sue Melton |
First Address | Honolulu, HI 96817-5018 |
Second Address | Honolulu, HI 96817-5018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2012 |
Last Update Date | 01/09/2021 |