Provider Demographics
NPI:1194389429
Name:MAHOR, MARICRIS SANGALANG (RN)
Entity Type:Individual
Prefix:
First Name:MARICRIS
Middle Name:SANGALANG
Last Name:MAHOR
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 1:94-552 WAIPAHU ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-1630
Mailing Address - Country:US
Mailing Address - Phone:808-343-7718
Mailing Address - Fax:
Practice Address - Street 1:94-552 WAIPAHU ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-1630
Practice Address - Country:US
Practice Address - Phone:808-343-7718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-22
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI63386163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool