Healthcare Provider Details

I. General information

NPI: 1417310921
Provider Name (Legal Business Name): SHANNON RHEA HALL DNP, CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 GADSDEN HWY
BIRMINGHAM AL
35235-3134
US

IV. Provider business mailing address

1801 GADSDEN HWY
BIRMINGHAM AL
35235-3134
US

V. Phone/Fax

Practice location:
  • Phone: 205-838-3900
  • Fax: 205-838-3906
Mailing address:
  • Phone: 205-838-3900
  • Fax: 205-838-3906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1-101887
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: