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General NPI Number Information
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NPI Number | 1558904169
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Entity Type | Individual
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Provider Name | ANTHONY JAMES HALL APRN
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Gender | Male
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Dates
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Enumeration Date | 10/26/2019
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Last Update Date | 05/13/2022
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Provider Practice Location Address
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Address Line | 1415 HIGHWAY 85 N # 310302
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7738
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Country | US
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Telephone | 678-551-7083
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Fax | 678-487-5367
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Provider Business Mailing Address
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Address Line | 1415 HIGHWAY 85 N # 310302
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7738
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Country | US
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Telephone | 678-551-7083
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Fax | 678-487-5367
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN200530
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License Number State | GA
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