Karisa Alana Deitch, RN, BSN

Individual provider Active NPI Registered Nurse · Pearl City, HI

NPI 1770075004 · NPPES record last updated Jun 1, 2018

Key facts

NPI
1770075004
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
81610 (HI)
Practice address
860 4TH St RM 205
Pearl City, HI 96782-3312
Phone
(808) 453-6224
Fax
(808) 453-5966
NPI assigned
Jun 1, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
95107923CAMDRegistered Nurse
81610HIMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95107923 CA
Registered Nurse 163W00000X 81610 HI Yes

Addresses

Primary practice location

860 4TH St RM 205
Pearl City, HI 96782-3312

Mailing address

860 4TH St RM 205
Pearl City, HI 96782-3312
Phone (808) 453-6224

Other providers in Pearl City, HI

All providers in Pearl City, HI · Registered Nurse in Hawaii

Sources for this page

Verify at the official NPI Registry.