MEDICARE: MS. GEORGIA CAMPBELL HALL NP

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	4045566	KY

General Provider Information

NPI Number	:	1689829814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GEORGIA CAMPBELL HALL NP

Provider Business Mailing Address
First Line	:	1301 W JFK DR
Second Line	:
City	:	NORTH VERNON
State	:	IN
Zip	:	47265-6117
Country	:	US
Telephone Number	:	812-346-9476
Fax Number	:	812-346-9493

Provider Business Practice Location Address
First Line	:	1301 W JFK DR
Second Line	:
City	:	NORTH VERNON
State	:	IN
Zip	:	47265-6117
Country	:	US
Telephone Number	:	812-346-9476
Fax Number	:	812-346-9493

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

Provider Enumeration Date	:	12/02/2008
Last Update Date	:	12/05/2025

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