Provider Demographics
NPI:1104013804
Name:MORAN, ANGELA SHRUM (RN)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:SHRUM
Last Name:MORAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6444A WEBB CT
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-5311
Mailing Address - Country:US
Mailing Address - Phone:808-224-1374
Mailing Address - Fax:
Practice Address - Street 1:480 CENTRAL AVENUE
Practice Address - Street 2:NAVAL HEALTH CLINIC HAWAII
Practice Address - City:PEARL HARBOR
Practice Address - State:HI
Practice Address - Zip Code:96860-4908
Practice Address - Country:US
Practice Address - Phone:808-471-1866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI54618163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management