Healthcare Provider Details

I. General information

NPI: 1306613831
Provider Name (Legal Business Name): ANNE M HALE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2023
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 E OVERLAND
SCOTTSBLUFF NE
69361-3602
US

IV. Provider business mailing address

2506 CIRCLE DR
SCOTTSBLUFF NE
69361-1779
US

V. Phone/Fax

Practice location:
  • Phone: 308-225-5330
  • Fax:
Mailing address:
  • Phone: 970-590-7902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4704259501
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704259501
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: