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General NPI Number Information
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NPI Number | 1801467261
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Entity Type | Individual
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Provider Name | JODIE ANNE HALL AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/07/2021
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 875 OAK ST SE STE 4030
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City | SALEM
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State | OR
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Zip | 97301-3984
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Country | US
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Telephone | 503-561-6444
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Fax | 503-561-6440
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Provider Business Mailing Address
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Address Line | 875 OAK ST SE STE 4030
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City | SALEM
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State | OR
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Zip | 97301-3984
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Country | US
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Telephone | 503-561-6444
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Fax | 503-561-6440
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | N261191889
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 202010835NP-PP
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License Number State | OR
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