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NPI Code Detail

MEDICARE: BRENDA B HALL CRNA

MEDICARE: BRENDA B HALL CRNA
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
1367500000XCertified Registered Nurse Anesthetist200589NC
2367500000XCertified Registered Nurse Anesthetist1022NC

General Provider Information

NPI Number : 1477603785
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA B HALL CRNA
Provider Business Mailing Address
First Line : 3100 SPRING FOREST RD
Second Line : SUITE 130
City : RALEIGH
State : NC
Zip : 27616-2880
Country : US
Telephone Number : 919-873-9533
Fax Number :
Provider Business Practice Location Address
First Line : 9104 MARKET ST
Second Line :
City : WILMINGTON
State : NC
Zip : 28411-7994
Country : US
Telephone Number : 910-686-2840
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2007
Last Update Date : 09/22/2025

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