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General NPI Number Information
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NPI Number | 1609383082
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Entity Type | Individual
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Provider Name | MICHAEL LYNN HALL DNPC APRN FNP PMHNP
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Gender | Male
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Dates
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Enumeration Date | 01/06/2018
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 4633 OLD IRONSIDES DR STE 304
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City | SANTA CLARA
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State | CA
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Zip | 95054-1846
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Country | US
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Telephone | 323-205-7088
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Fax | 731-207-7611
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Provider Business Mailing Address
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Address Line | 728 N SAMPSON AVE
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City | DYERSBURG
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State | TN
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Zip | 38024-3962
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Country | US
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Telephone | 323-205-7088
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Fax | 731-207-7611
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 23860
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NP95017742
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 23860
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License Number State | TN
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