MEDICARE: MRS. REBECCA JOAN HALL FNP-BC, APNP

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	363LF0000X	Family Nurse Practitioner	9375314	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962485474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. REBECCA JOAN HALL FNP-BC, APNP

Provider Business Mailing Address
First Line	:	8879 FOXTAIL LOOP
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32526-3236
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12601 SORRENTO RD
Second Line	:	SUITE B
City	:	PENSACOLA
State	:	FL
Zip	:	32507-8762
Country	:	US
Telephone Number	:	850-437-5686
Fax Number	:

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

Provider Enumeration Date	:	11/29/2005
Last Update Date	:	04/02/2014

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