Healthcare Provider Details

I. General information

NPI: 1700971306
Provider Name (Legal Business Name): SYLVIA B HALLA RN CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4712 HAMPTON BLVD
NORFOLK VA
23508-1800
US

IV. Provider business mailing address

120 FAYTON AVE
NORFOLK VA
23505-4428
US

V. Phone/Fax

Practice location:
  • Phone: 757-489-4848
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001074175
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number0230004552
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: