Healthcare Provider Details

I. General information

NPI: 1487583142
Provider Name (Legal Business Name): JENNIFER MICHELLE HALL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER MORRISETTE

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 AVENUE H
SCOTTSBLUFF NE
69361-2346
US

IV. Provider business mailing address

1705 AVENUE H
SCOTTSBLUFF NE
69361-2346
US

V. Phone/Fax

Practice location:
  • Phone: 308-765-6727
  • Fax:
Mailing address:
  • Phone: 308-765-6727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: