Healthcare Provider Details

I. General information

NPI: 1730111360
Provider Name (Legal Business Name): CARRIE JEANNINE HALL APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

571 S ALLEN RD
FLAT ROCK NC
28731-9447
US

IV. Provider business mailing address

571 S ALLEN RD
FLAT ROCK NC
28731-9447
US

V. Phone/Fax

Practice location:
  • Phone: 828-692-6178
  • Fax: 828-692-2365
Mailing address:
  • Phone: 828-692-6178
  • Fax: 828-692-2365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5018046
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1010059379
License Number StateVT
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number046828-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: