Provider Demographics
NPI:1477378974
Name:HALLUM, SHAWN ANTHONY (NBC-HWC)
Entity type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:ANTHONY
Last Name:HALLUM
Suffix:
Gender:M
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 KEONELOA ST
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2448
Mailing Address - Country:US
Mailing Address - Phone:917-880-9692
Mailing Address - Fax:
Practice Address - Street 1:144 KEONELOA ST
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2448
Practice Address - Country:US
Practice Address - Phone:917-880-9692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach