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NPI Code Detail

MEDICARE: MS. JEANINE HALL BSW

MEDICARE: MS. JEANINE HALL BSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1295056646
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JEANINE HALL BSW
Provider Business Mailing Address
First Line : 1604 RIO BRAVO DR
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-1016
Country : US
Telephone Number : 615-801-7630
Fax Number :
Provider Business Practice Location Address
First Line : 3171 S JONES BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-6703
Country : US
Telephone Number : 702-586-8693
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2010
Last Update Date : 02/23/2015

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