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General NPI Number Information
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NPI Number | 1700226040
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Entity Type | Individual
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Provider Name | NAKEDA LASHON HALL APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 07/01/2013
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 110 NW 31ST ST STE 201
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City | LAWTON
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State | OK
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Zip | 73505-6100
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Country | US
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Telephone | 580-585-5549
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Fax |
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Provider Business Mailing Address
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Address Line | 509 BISCAYNE LN
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City | ELGIN
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State | OK
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Zip | 73538-5005
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Country | US
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Telephone | 580-284-5058
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R0087087
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R0087087
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License Number State | OK
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