Provider Demographics
NPI:1942688593
Name:HIRAM, PRISCILLA (RN)
Entity Type:Individual
Prefix:MISS
First Name:PRISCILLA
Middle Name:
Last Name:HIRAM
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 1:8422 BELLONA LN STE 205
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2057
Mailing Address - Country:US
Mailing Address - Phone:410-821-9800
Mailing Address - Fax:410-821-9801
Practice Address - Street 1:8422 BELLONA LN STE 205
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2057
Practice Address - Country:US
Practice Address - Phone:410-821-9800
Practice Address - Fax:410-821-9801
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-15
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3715251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health