Healthcare Provider Details

I. General information

NPI: 1184957052
Provider Name (Legal Business Name): ROBERT FRANKLIN HALL III CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2009
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1953 INDIANWOOD CT
RALEIGH NC
27604
US

IV. Provider business mailing address

4200 LAKE BOONE TRL
RALEIGH NC
27607-6521
US

V. Phone/Fax

Practice location:
  • Phone: 704-239-5890
  • Fax:
Mailing address:
  • Phone: 919-784-3241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number001775
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number178785
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9476934
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number178785
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: