Healthcare Provider Details

I. General information

NPI: 1629692298
Provider Name (Legal Business Name): AT HOME VISIT, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2020
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 STATE HIGHWAY 1947
GRAYSON KY
41143-8803
US

IV. Provider business mailing address

915 STATE HIGHWAY 1947
GRAYSON KY
41143-8803
US

V. Phone/Fax

Practice location:
  • Phone: 606-315-3700
  • Fax: 833-944-0284
Mailing address:
  • Phone: 606-315-3700
  • Fax: 833-944-0284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NATHANA D HALL
Title or Position: OWNER
Credential: APRN, MSN, FNP-C
Phone: 606-483-6021