Provider Demographics
NPI:1265815732
Name:HALL, AMY BETH (CRNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:BETH
Last Name:HALL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 E TENNESSEE ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-5655
Mailing Address - Country:US
Mailing Address - Phone:256-764-9830
Mailing Address - Fax:256-764-9832
Practice Address - Street 1:122 E TENNESSEE ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5655
Practice Address - Country:US
Practice Address - Phone:256-764-9830
Practice Address - Fax:256-764-9832
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-124893363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily