Shull, Grayden J

Shull, Grayden J is an individual health care provider with primary practice located at 3288 Moanalua Rd , Honolulu HI 96819-1469. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Shull, Grayden J can be contacted via phone (808) 432-0000.

Contact Information

Primary practice address
3288 Moanalua Rd Honolulu HI 96819-1469
Phone: (808) 432-0000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 4704230718 Michigan

Profile Details

NPI number 1902888191
LBN Legal business name Shull, Grayden J
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2005
Last updated Apr 19th, 2021 - about 3 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 1902888191 NPPES
Wisconsin Other 44343100 WISC MEDICAID
Wisconsin Other GS230718 WISC MEDICAID
Wisconsin MEDICAID 104782094 WISC MEDICAID

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