Healthcare Provider Details

I. General information

NPI: 1003779216
Provider Name (Legal Business Name): D'ANTAYE L HALL RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FRANKLIN COUNTY CRISIS CARE CENTER 465 HARMON AVE
COLUMBUS OH
43223
US

IV. Provider business mailing address

11361 N 99TH AVE STE 402
PEORIA AZ
85345-5459
US

V. Phone/Fax

Practice location:
  • Phone: 614-222-3737
  • Fax: 614-358-4201
Mailing address:
  • Phone: 602-650-1212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number420558
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: