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NPI Code Detail

MEDICARE: NICHOLE HALL

MEDICARE: NICHOLE HALL
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2363L00000XNurse PractitionerLPN.162146.MEDS-IVOH

General Provider Information

NPI Number : 1639641905
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLE HALL
Provider Business Mailing Address
First Line : 7540 NEW WEST RD
Second Line :
City : TOLEDO
State : OH
Zip : 43617-4200
Country : US
Telephone Number : 866-203-0308
Fax Number :
Provider Business Practice Location Address
First Line : 7540 NEW WEST RD
Second Line :
City : TOLEDO
State : OH
Zip : 43617-4200
Country : US
Telephone Number : 866-203-0308
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2018
Last Update Date : 06/27/2019

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Directions to “ NICHOLE HALL ” Practice Location

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