MEDICARE: RONALD HALL PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	661981	TX

General Provider Information

NPI Number	:	1700281516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD HALL PMHNP

Provider Business Mailing Address
First Line	:	1808 ROSE ST
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76301-4219
Country	:	US
Telephone Number	:	940-322-9456
Fax Number	:	940-723-4490

Provider Business Practice Location Address
First Line	:	1410 8TH ST
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76301-3105
Country	:	US
Telephone Number	:	940-264-8818
Fax Number	:	940-264-8819

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

Provider Enumeration Date	:	10/23/2014
Last Update Date	:	04/24/2025

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