Healthcare Provider Details

I. General information

NPI: 1457466229
Provider Name (Legal Business Name): JEANNE LOUISE HALL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3105 N 93RD ST
OMAHA NE
68134-4717
US

IV. Provider business mailing address

3105 N 93RD ST
OMAHA NE
68134-4717
US

V. Phone/Fax

Practice location:
  • Phone: 800-230-7526
  • Fax: 651-696-5543
Mailing address:
  • Phone: 800-230-7526
  • Fax: 651-696-5543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number112751
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60338784
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60338784
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number45084
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: