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General NPI Number Information
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NPI Number | 1790300903
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Entity Type | Organization
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Legal Business Name | HALL DIABETES MANAGEMENT AND RESOURCE CENTER PC
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Dates
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Enumeration Date | 06/12/2020
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Last Update Date | 07/23/2020
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Provider Practice Location Address
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Address Line | 1900 E NORTHERN PKWY STE T1
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City | BALTIMORE
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State | MD
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Zip | 21239-2120
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Country | US
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Telephone | 443-676-5422
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 E NORTHERN PKWY STE T1
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City | BALTIMORE
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State | MD
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Zip | 21239-2120
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Country | US
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Telephone | 443-676-5422
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Fax |
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Authorized Official
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Title or Position | OWNER/NURSE PRACTITIONER
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Name | MRS. ERICA HALL
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Credential | ANP-BC
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Telephone | 443-676-5422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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