Healthcare Provider Details

I. General information

NPI: 1346455540
Provider Name (Legal Business Name): MS. AMY HALL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 07/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 CAPITAL DR SUITE C
WEST SPRINGFIELD MA
01089-1350
US

IV. Provider business mailing address

25 HASTINGS ST
GREENFIELD MA
01301-2006
US

V. Phone/Fax

Practice location:
  • Phone: 413-746-1079
  • Fax: 413-746-5077
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: