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NPI Code Detail

MEDICARE: ANGELA HALL CRNP

MEDICARE: ANGELA HALL CRNP
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
1363LF0000XFamily Nurse PractitionerF0214448AL

General Provider Information

NPI Number : 1750753422
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA HALL CRNP
Provider Business Mailing Address
First Line : 4300W MAIN ST 403
Second Line :
City : DOTHAN
State : AL
Zip : 36305-1314
Country : US
Telephone Number : 334-673-7312
Fax Number :
Provider Business Practice Location Address
First Line : 4300 W MAIN ST STE 403
Second Line :
City : DOTHAN
State : AL
Zip : 36305-1314
Country : US
Telephone Number : 334-673-7312
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2015
Last Update Date : 10/21/2015

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