Provider Demographics
NPI:1023210879
Name:HALLE, ROBIN A (CRNA)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:A
Last Name:HALLE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5910 LANDERBROOK DR
Mailing Address - Street 2:SUITE250
Mailing Address - City:MAYFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-6508
Mailing Address - Country:US
Mailing Address - Phone:440-684-5843
Mailing Address - Fax:440-449-1555
Practice Address - Street 1:11100 EULCID AVENUE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106
Practice Address - Country:US
Practice Address - Phone:216-844-3777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN329713367500000X
OHNA-09188367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered