Basic Information
| Provider Information | |||||||||
| NPI: | 1952948879 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOWNEY | ||||||||
| FirstName: | KATRINA | ||||||||
| MiddleName: | ELISE | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 73-1221 KUAKAPU ST | ||||||||
| Address2: | |||||||||
| City: | KAILUA KONA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967409360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3602597308 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 78-6831 ALII DR STE 300 | ||||||||
| Address2: | |||||||||
| City: | KAILUA KONA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967405401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8083226627 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/10/2019 | ||||||||
| LastUpdateDate: | 05/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | PH4493 | HI | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.