| Doctor Name: | MS. KELLY LEIALOHA LUSCOMB |
| NPI Number: | 1053746941 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | APRN-1641 |
| Business Practice Address: | 80 Pauahi St Ste 101 Hilo, HI - 967203043 |
| Business Phone Number: | 8085317222 |
| Business Fax Number: | |
| Mailing Address: | 80 Pauahi St Ste 101, HILO |
| State: | HI |
| Postal Code: | 967203043 |
| Phone Number: | 8085317222 |
| Fax Number: | |
| NPI Enumeration Date: | 09/10/2013 |
| NPI Last Update Date: | 02/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | APRN-1641 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | HI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |