Provider Demographics
NPI:1447737481
Name:MOSES, JOHN PAUL III (APRN)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:PAUL
Last Name:MOSES
Suffix:III
Gender:M
Credentials:APRN
Other - Prefix:MR
Other - First Name:JOHN
Other - Middle Name:ANTHONY
Other - Last Name:MOSES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, RN
Mailing Address - Street 1:PO BOX 894436
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-8324
Mailing Address - Country:US
Mailing Address - Phone:808-782-1113
Mailing Address - Fax:
Practice Address - Street 1:44-174 LAHA ST # 1904
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-2636
Practice Address - Country:US
Practice Address - Phone:808-782-1113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2488363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily