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NPI Code Detail

MEDICARE: CHRISTINE M. HALL P.A.-C

MEDICARE: CHRISTINE M. HALL P.A.-C
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
1363AM0700XMedical Physician AssistantPA-468ID

General Provider Information

NPI Number : 1366494650
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE M. HALL P.A.-C
Provider Business Mailing Address
First Line : PO BOX 191050
Second Line :
City : BOISE
State : ID
Zip : 83719-1050
Country : US
Telephone Number : 208-955-6500
Fax Number : 208-955-6503
Provider Business Practice Location Address
First Line : 6052 W STATE ST
Second Line :
City : BOISE
State : ID
Zip : 83703-2739
Country : US
Telephone Number : 208-344-7799
Fax Number : 208-344-7152
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 10/13/2022

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