Healthcare Provider Details

I. General information

NPI: 1093703449
Provider Name (Legal Business Name): CONNIE MICHELLE HALE CNM, MSN, LNC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 09/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11097 HEARTH RD
SPRING HILL FL
34608-3704
US

IV. Provider business mailing address

11097 HEARTH RD
SPRING HILL FL
34608-3704
US

V. Phone/Fax

Practice location:
  • Phone: 352-263-2600
  • Fax: 352-684-2218
Mailing address:
  • Phone: 352-263-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberARNP 2053942
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: