Individual
LAURA J ANKRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
75-5751 KUAKINI HWY STE 101A, KAILUA KONA, HI 96740-1705
(808) 326-5629
Mailing address
75-5751 KUAKINI HWY STE 203, KAILUA KONA, HI 96740-1753
(808) 326-5629
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
46621 021
WI
207Q00000X
Family Medicine Physician
5101014524
MI
207Q00000X
Family Medicine Physician
Primary
DOS-1552
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43512500
—
WI
05
—
4606346
—
MI
05
—
4606364
—
MI
05
—
762543
—
HI
Enumeration date
02/10/2006
Last updated
02/25/2021
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