Healthcare Provider Details

I. General information

NPI: 1932312964
Provider Name (Legal Business Name): ANNE MARIE G HALL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 JOHNSON ST
HOLLYWOOD FL
33021-5421
US

IV. Provider business mailing address

802 SW 117TH AVE
PEMBROKE PINES FL
33025-3480
US

V. Phone/Fax

Practice location:
  • Phone: 954-265-3166
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP3216632
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: