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General NPI Number Information
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NPI Number | 1629198478
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Entity Type | Individual
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Provider Name | KELLY HALL NP
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Gender | Female
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 1194 OAK VALLEY DR STE 80B
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City | ANN ARBOR
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State | MI
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Zip | 48108-8942
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Country | US
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Telephone | 734-975-5000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 639295
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City | CINCINNATI
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State | OH
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Zip | 45263-9295
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Country | US
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Telephone | 248-824-6000
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Fax | 855-618-6655
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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 | 4704190838
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License Number State | MI
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