MEDICARE: HALLE BONNER MED

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1770430076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALLE BONNER MED

Provider Business Mailing Address
First Line	:	6001 HUGHES XING
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37064-4126
Country	:	US
Telephone Number	:	865-712-4161
Fax Number	:

Provider Business Practice Location Address
First Line	:	5217 MARYLAND WAY
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-1400
Country	:	US
Telephone Number	:	615-882-1792
Fax Number	:

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

Provider Enumeration Date	:	03/14/2026
Last Update Date	:	03/14/2026

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Directions to “ HALLE BONNER MED” Practice Location

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