Healthcare Provider Details

I. General information

NPI: 1104080761
Provider Name (Legal Business Name): JOELLA CAULEY HALL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2008
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 ERIC DR
PALM COAST FL
32164-6239
US

IV. Provider business mailing address

16 ERIC DR
PALM COAST FL
32164-6239
US

V. Phone/Fax

Practice location:
  • Phone: 386-562-7709
  • Fax:
Mailing address:
  • Phone: 386-562-7709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP9216912
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: