Provider Demographics
NPI:1013044528
Name:HALL, DEVONNE P (LPN)
Entity Type:Individual
Prefix:MS
First Name:DEVONNE
Middle Name:P
Last Name:HALL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:88005 OVERSEAS HIGHWAY
Mailing Address - Street 2:SUITE 16
Mailing Address - City:ISLAMORADA
Mailing Address - State:FL
Mailing Address - Zip Code:33036
Mailing Address - Country:US
Mailing Address - Phone:315-593-9711
Mailing Address - Fax:305-425-2228
Practice Address - Street 1:88005 OVERSEAS HIGHWAY
Practice Address - Street 2:SUITE 16
Practice Address - City:ISLAMORADA
Practice Address - State:FL
Practice Address - Zip Code:33036
Practice Address - Country:US
Practice Address - Phone:315-593-9711
Practice Address - Fax:305-425-2228
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY204741-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002909900Medicaid
NY02498231Medicaid