MEDICARE: MELISSA MARGARET HALL APRN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	3013385	KY

General Provider Information

NPI Number	:	1437791134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA MARGARET HALL APRN

Provider Business Mailing Address
First Line	:	4729 OPUS DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-8694
Country	:	US
Telephone Number	:	719-289-3173
Fax Number	:

Provider Business Practice Location Address
First Line	:	4729 OPUS DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-8694
Country	:	US
Telephone Number	:	719-289-3173
Fax Number	:	866-718-1677

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

Provider Enumeration Date	:	10/14/2019
Last Update Date	:	05/19/2026

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