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General NPI Number Information
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NPI Number | 1003538281
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Entity Type | Individual
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Provider Name | REBECCA LYNN HALE
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Gender | Female
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Dates
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Enumeration Date | 09/14/2022
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Last Update Date | 02/16/2023
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Provider Practice Location Address
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Address Line | 271 GRANT AVE STE 100
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City | AUBURN
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State | NY
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Zip | 13021-1407
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Country | US
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Telephone | 315-704-1407
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Fax | 315-704-6098
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Provider Business Mailing Address
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Address Line | 200 ELM ST
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City | ILION
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State | NY
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Zip | 13357-2504
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Country | US
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Telephone | 315-360-3963
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 351267
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License Number State | NY
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