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General NPI Number Information
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NPI Number | 1215650783
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Entity Type | Individual
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Provider Name | TYLER HALL APRN
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Gender | Male
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Dates
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Enumeration Date | 09/20/2022
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 9000 N MAIN ST
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City | ENGLEWOOD
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State | OH
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Zip | 45415-1180
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Country | US
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Telephone | 937-734-6784
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Fax |
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Provider Business Mailing Address
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Address Line | 426 CLINTON ST
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City | CLAYTON
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State | OH
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Zip | 45315-8965
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Country | US
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Telephone | 937-308-2268
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.0032342
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN.CNP.0032342
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License Number State | OH
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