Healthcare Provider Details

I. General information

NPI: 1780473496
Provider Name (Legal Business Name): ASHLEY IRIS HALL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 N GEORGE MASON DR
ARLINGTON VA
22205-3683
US

IV. Provider business mailing address

2738 KING IRON CT
WOODBRIDGE VA
22192-1210
US

V. Phone/Fax

Practice location:
  • Phone: 703-558-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number0001295402
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: