MEDICARE: MRS. FREDDA A HALL R.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN154135L	PA

General Provider Information

NPI Number	:	1013136233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FREDDA A HALL R.N.

Provider Business Mailing Address
First Line	:	2801 LORI DR
Second Line	:
City	:	LOWER BURRELL
State	:	PA
Zip	:	15068-3603
Country	:	US
Telephone Number	:	724-337-4218
Fax Number	:

Provider Business Practice Location Address
First Line	:	907 WEST ST
Second Line	:	2ND FLOOR
City	:	PITTSBURGH
State	:	PA
Zip	:	15221-2838
Country	:	US
Telephone Number	:	412-247-7806
Fax Number	:	412-247-7959

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	07/08/2007

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