Provider Demographics
NPI:1700864808
Name:MOYER, CHRISTINA H (PA-C, MPAS, DHSC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:H
Last Name:MOYER
Suffix:
Gender:F
Credentials:PA-C, MPAS, DHSC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:HAYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1292 WAIANUENUE AVE
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-1228
Mailing Address - Country:US
Mailing Address - Phone:808-934-4000
Mailing Address - Fax:
Practice Address - Street 1:1292 WAIANUENUE AVE
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-1228
Practice Address - Country:US
Practice Address - Phone:808-934-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5090363A00000X
HIAMD-867363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN