| Organization Name: | KA HOAILONA RURAL HEALTH CLINIC |
| NPI Number: | 1982978904 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY LOUISE HOFFMAN (OWNER) |
| Mailing Address: | 107b Ala Malama St Kaunakakai |
| State: | HI US |
| Postal Code: | 96748 |
| Phone Number: | 8085534368 |
| Fax Number: | 8883882307 |
| NPI Enumeration Date: | 03/08/2012 |
| NPI Last Update Date: | 01/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 865 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | HI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |