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General NPI Number Information
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NPI Number | 1619619541
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Entity Type | Individual
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Provider Name | ELIZABETH HALL
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Gender | Female
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Dates
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Enumeration Date | 04/11/2022
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Last Update Date | 04/11/2022
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Provider Practice Location Address
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Address Line | 8915 W CONNELL AVE
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City | MILWAUKEE
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State | WI
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Zip | 53226-3067
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Country | US
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Telephone | 414-266-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 4421 HILLSIDE RD
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City | WATERFORD
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State | WI
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Zip | 53185-3912
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Country | US
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Telephone |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 220642-30
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License Number State | WI
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