Provider Demographics
NPI:1952120297
Name:COSMIAN, CAITLIN MALIA (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:MALIA
Last Name:COSMIAN
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 ULUHAO ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4421
Mailing Address - Country:US
Mailing Address - Phone:808-859-7728
Mailing Address - Fax:
Practice Address - Street 1:642 ULUKAHIKI ST STE 305
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4439
Practice Address - Country:US
Practice Address - Phone:808-263-5433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIL-312594163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant