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NPI Code Detail

MEDICARE: CHRISTINA LYNN HALL IS

MEDICARE:   CHRISTINA LYNN HALL  IS
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
1106S00000XBehavior TechnicianID

General Provider Information

NPI Number : 1962381012
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA LYNN HALL IS
Provider Business Mailing Address
First Line : 201 MAPLE ST APT 2
Second Line :
City : IDAHO FALLS
State : ID
Zip : 83402-4103
Country : US
Telephone Number : 208-757-9568
Fax Number :
Provider Business Practice Location Address
First Line : 201 MAPLE ST APT 2
Second Line :
City : IDAHO FALLS
State : ID
Zip : 83402-4103
Country : US
Telephone Number : 208-757-9568
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2025
Last Update Date : 09/01/2025

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Directions to “ CHRISTINA LYNN HALL IS” Practice Location

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