Provider Demographics
NPI:1073188140
Name:HALL, TOSHANNA
Entity Type:Individual
Prefix:
First Name:TOSHANNA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5934 KOHLER LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-5486
Mailing Address - Country:US
Mailing Address - Phone:484-903-9688
Mailing Address - Fax:
Practice Address - Street 1:5830 NEWTOWN ARCH
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3245
Practice Address - Country:US
Practice Address - Phone:484-903-9688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker