MEDICARE: MRS. SUSAN JOANN HALL MSN, APRN, WHNP

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	364SN0000X	Neonatal Clinical Nurse Specialist	202720-4405	UT

General Provider Information

NPI Number	:	1982738043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN JOANN HALL MSN, APRN, WHNP

Provider Business Mailing Address
First Line	:	PO BOX 413028
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84141-3028
Country	:	US
Telephone Number	:	801-213-3900
Fax Number	:	801-585-3655

Provider Business Practice Location Address
First Line	:	50 N MEDICAL DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84132-0001
Country	:	US
Telephone Number	:	801-213-2995
Fax Number	:	801-585-5146

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	12/20/2013

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