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NPI Code Detail

MEDICARE: JEREMY BRUCE HALL CRNA

MEDICARE: JEREMY BRUCE HALL CRNA
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
1207L00000XAnesthesiology Physician1-122082AL

General Provider Information

NPI Number : 1811869159
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEREMY BRUCE HALL CRNA
Provider Business Mailing Address
First Line : 1326 MOUNTAIN LN
Second Line :
City : GARDENDALE
State : AL
Zip : 35071-4200
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1802 6TH AVE S
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35233-1932
Country : US
Telephone Number : 205-934-3411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2025
Last Update Date : 05/27/2026

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