Provider Demographics
NPI:1609258086
Name:HALL-MORIYASU, MARNY (MSN)
Entity Type:Individual
Prefix:
First Name:MARNY
Middle Name:
Last Name:HALL-MORIYASU
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16441 HALEAKALA HWY
Mailing Address - Street 2:
Mailing Address - City:KULA
Mailing Address - State:HI
Mailing Address - Zip Code:96790-8023
Mailing Address - Country:US
Mailing Address - Phone:808-283-7951
Mailing Address - Fax:
Practice Address - Street 1:85 MAUI LANI PKWY
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2416
Practice Address - Country:US
Practice Address - Phone:808-442-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-23
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI32427163WD0400X
HIAPRN-3730364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator