Basic Information
| Provider Information | |||||||||
| NPI: | 1679888119 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HALL | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | DEAN | ||||||||
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| Credential: | APRN, NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 145 CITIZENS LN | ||||||||
| Address2: | SUITE B | ||||||||
| City: | HAZARD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 417011320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064357642 | ||||||||
| FaxNumber: | 6064365282 | ||||||||
| Practice Location | |||||||||
| Address1: | 145 CITIZENS LN | ||||||||
| Address2: | SUITE B | ||||||||
| City: | HAZARD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 417011320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064357642 | ||||||||
| FaxNumber: | 6064365282 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2010 | ||||||||
| LastUpdateDate: | 06/20/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 6475P | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.