Individual
DR. KATHLEEN FANSHAW IANNITELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
121 MAHALANI ST, WAILUKU, HI 96793-2528
(808) 984-2150
(808) 984-2155
Mailing address
570 MAALAHI ST, WAILUKU, HI 96793-1541
(808) 244-0961
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD5702
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51655
ALOHA CARE
HI
05
—
53937204
—
HI
Enumeration date
12/06/2006
Last updated
07/08/2007
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