MEDICARE: SYLVIA B HALLA RN CPHT

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	0001074175	VA
2	183700000X	Pharmacy Technician	0230004552	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0001074175	OTHER	VA	RN
2	0230004552	OTHER	VA	CPHT

General Provider Information

NPI Number	:	1700971306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYLVIA B HALLA RN CPHT

Provider Business Mailing Address
First Line	:	120 FAYTON AVE
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23505-4428
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4712 HAMPTON BLVD
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23508-1800
Country	:	US
Telephone Number	:	757-489-4848
Fax Number	:

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	09/11/2025

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