Provider Demographics
NPI:1871125641
Name:NEWMAN, KATE (PA-C)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41-363 SADDLE CITY RD UNIT 17
Mailing Address - Street 2:
Mailing Address - City:WAIMANALO
Mailing Address - State:HI
Mailing Address - Zip Code:96795-1157
Mailing Address - Country:US
Mailing Address - Phone:916-216-9503
Mailing Address - Fax:
Practice Address - Street 1:770 KAPIOLANI BLVD STE 705
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5241
Practice Address - Country:US
Practice Address - Phone:808-597-8799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-10
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA9581363A00000X
HIAMD-1271-0363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant