Moore, Jacob W

Moore, Jacob W is an individual health care provider with primary practice located at 550 S Beretania St Ste 601 , Honolulu HI 96813-2423. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as his primary health care specialty. Moore, Jacob W can be contacted via phone (808) 691-8877.

Contact Information

Primary practice address
550 S Beretania St Ste 601 Honolulu HI 96813-2423
Phone: (808) 691-8877
Fax: (808) 691-8875
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X APRN-558 Hawaii

Profile Details

NPI number 1023165610
LBN Legal business name Moore, Jacob W
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2007
Last updated Jul 21st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023165610 NPPES
Hawaii MEDICAID 55115201
Hawaii Other 0000245274

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