MEDICARE: RAYNA HALL LMT, RN, FNP-BC

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	RN.414629	OH
2	174400000X	Specialist	33.016347	OH
3	225700000X	Massage Therapist	33.016347	OH
4	363LF0000X	Family Nurse Practitioner	APRN.CNP.0036427	OH

General Provider Information

NPI Number	:	1467684670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYNA HALL LMT, RN, FNP-BC

Provider Business Mailing Address
First Line	:	6611 CLYO RD STE A
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45459-2785
Country	:	US
Telephone Number	:	937-208-7300
Fax Number	:

Provider Business Practice Location Address
First Line	:	6611 CLYO RD STE A
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45459-2785
Country	:	US
Telephone Number	:	937-208-7300
Fax Number	:	937-208-7330

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

Provider Enumeration Date	:	08/20/2009
Last Update Date	:	09/04/2024

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