Individual
KELSIE FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3627 KILAUEA AVE RM 101, HONOLULU, HI 96816-2317
(808) 733-9354
Mailing address
98-518 KILIOHU LOOP, AIEA, HI 96701-2150
(808) 321-8287
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
HI
Other
Enumeration date
08/29/2019
Last updated
08/29/2019
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