# KELLIE M. O. TAKASHIMA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1568544401
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 339604 | NY | — |
| 363L00000X | Nurse Practitioner | 95002446 | CA | Yes |
| 363LF0000X | Family Nurse Practitioner | AP60755079 | WA | — |
| 363LF0000X | Family Nurse Practitioner | AP7772 | AZ | — |
| 363LF0000X | Family Nurse Practitioner | RN2300400 | MA | — |

## Other

- **Enumeration date:** 10/19/2006
- **Last updated:** 10/02/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0000220004 | HMSA BILLING NUMBER | HI |
| 05 | — | 55037802 | — | HI |