MEDICARE: MRS. VIRGINIA KATE HALLMAN FNP

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
1	163W00000X	Registered Nurse	1634112	CO
2	363L00000X	Nurse Practitioner	APN.0999586-NP	CO

General Provider Information

NPI Number	:	1437932753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VIRGINIA KATE HALLMAN FNP

Provider Business Mailing Address
First Line	:	403 MAXINE DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-6836
Country	:	US
Telephone Number	:	970-640-2209
Fax Number	:

Provider Business Practice Location Address
First Line	:	1475 PINE GROVE RD STE 102
Second Line	:
City	:	STEAMBOAT SPRINGS
State	:	CO
Zip	:	80487-8851
Country	:	US
Telephone Number	:	970-879-0203
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2023
Last Update Date	:	10/24/2024

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