Basic Information
| Provider Information | |||||||||
| NPI: | 1528373545 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HALL | ||||||||
| FirstName: | CHRISTY | ||||||||
| MiddleName: | MICHELLE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MSN, NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5900 SIX FORKS RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276093838 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198764327 | ||||||||
| FaxNumber: | 9198766800 | ||||||||
| Practice Location | |||||||||
| Address1: | 5838 SIX FORKS RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276093885 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197853400 | ||||||||
| FaxNumber: | 9197837778 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2010 | ||||||||
| LastUpdateDate: | 02/11/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 5004796 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.