Healthcare Provider Details

I. General information

NPI: 1427331958
Provider Name (Legal Business Name): DIANN B. HALL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2011
Last Update Date: 09/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2437 ALOHA LN
MIDDLEBURG FL
32068-7744
US

IV. Provider business mailing address

2437 ALOHA LN
MIDDLEBURG FL
32068-7744
US

V. Phone/Fax

Practice location:
  • Phone: 904-215-2266
  • Fax: 904-215-2266
Mailing address:
  • Phone: 904-215-2266
  • Fax: 904-215-2266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN 099533
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: