Basic Information
| Provider Information | |||||||||
| NPI: | 1508454976 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HALL | ||||||||
| FirstName: | EMILY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2001 RED OAK LN | ||||||||
| Address2: | |||||||||
| City: | CLAYTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275209166 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198175308 | ||||||||
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| Practice Location | |||||||||
| Address1: | 801 POOLE DR | ||||||||
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| City: | GARNER | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275295207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197791440 | ||||||||
| FaxNumber: | 9196620613 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/01/2021 | ||||||||
| LastUpdateDate: | 10/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | L003859 | NC | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.