MEDICARE: JEANNE LOUISE HALL 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	363LF0000X	Family Nurse Practitioner	112751	NE
2	363L00000X	Nurse Practitioner	AP60338784	WA
3	363LF0000X	Family Nurse Practitioner	AP60338784	WA
4	363L00000X	Nurse Practitioner	45084	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	111246	OTHER	KS	BC/BS SPEARVILLE

General Provider Information

NPI Number	:	1457466229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNE LOUISE HALL FNP

Provider Business Mailing Address
First Line	:	3105 N 93RD ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68134-4717
Country	:	US
Telephone Number	:	800-230-7526
Fax Number	:	651-696-5543

Provider Business Practice Location Address
First Line	:	3105 N 93RD ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68134-4717
Country	:	US
Telephone Number	:	800-230-7526
Fax Number	:	651-696-5543

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

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	03/12/2026

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