Healthcare Provider Details

I. General information

NPI: 1134520018
Provider Name (Legal Business Name): CHRISTOPHER TIMOTHY HALL APRN, RNFA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2014
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3237 SUSILEEN DR
RENO NV
89509-3859
US

IV. Provider business mailing address

75 PRINGLE WAY STE 1002
RENO NV
89502-1475
US

V. Phone/Fax

Practice location:
  • Phone: 775-313-7779
  • Fax:
Mailing address:
  • Phone: 775-323-7500
  • Fax: 775-789-9208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN60561
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN002618
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: