Provider Demographics
NPI:1073996237
Name:HALL, CORTEZ ARNOLD (RN,BSN)
Entity Type:Individual
Prefix:
First Name:CORTEZ
Middle Name:ARNOLD
Last Name:HALL
Suffix:
Gender:M
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 AMMONS DR N
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-7449
Mailing Address - Country:US
Mailing Address - Phone:336-708-1843
Mailing Address - Fax:336-448-1348
Practice Address - Street 1:1624 AMMONS DR N
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-7449
Practice Address - Country:US
Practice Address - Phone:336-708-1843
Practice Address - Fax:336-448-1348
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC146579163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse