Healthcare Provider Details

I. General information

NPI: 1265693642
Provider Name (Legal Business Name): JENNIFER M HALL CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2008
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27713 LORAIN RD
NORTH OLMSTED OH
44070-4019
US

IV. Provider business mailing address

27713 LORAIN RD
NORTH OLMSTED OH
44070-4019
US

V. Phone/Fax

Practice location:
  • Phone: 440-716-5166
  • Fax:
Mailing address:
  • Phone: 440-716-5166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number03742-NP
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN227358
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: