Brian R Moylan, BSN, RN

Individual provider Active NPI Home Health Registered Nurse · Barrigada, GU

NPI 1174833099 · NPPES record last updated Oct 13, 2010

Key facts

NPI
1174833099
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Registered Nurse 163WH0200X
License
RX0524 (GU)
Practice address
988 Army Dr.
Ste. 4
Barrigada, GU 96913
Phone
(671) 475-4005
Fax
(671) 475-4006
NPI assigned
Oct 13, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RX0524GUMDHome Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X RX0524 GU Yes

Addresses

Primary practice location

988 Army Dr.
Ste. 4
Barrigada, GU 96913

Mailing address

P.O. Box 217787
GMF Barrigada, GU 96921
Phone (671) 475-4005

Other providers in Barrigada, GU

All providers in Barrigada, GU · Home Health Registered Nurse in Guam

Sources for this page

Verify at the official NPI Registry.