Healthcare Provider Details

I. General information

NPI: 1932623576
Provider Name (Legal Business Name): SHANNON LEIGH HALL-MILLION DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2017
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 LIMESTONE ST S STE 1A
FRANKFORT KY
40601-4320
US

IV. Provider business mailing address

PO BOX 776879
CHICAGO IL
60677-6879
US

V. Phone/Fax

Practice location:
  • Phone: 502-223-8400
  • Fax: 502-875-3073
Mailing address:
  • Phone: 502-588-9490
  • Fax: 502-272-5116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number3011576
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: