Provider Demographics
NPI:1295363653
Name:HALL, SIERRA WYNELL (STNA)
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:WYNELL
Last Name:HALL
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4197 WILMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3136
Mailing Address - Country:US
Mailing Address - Phone:216-835-5986
Mailing Address - Fax:
Practice Address - Street 1:4197 WILMINGTON RD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-3136
Practice Address - Country:US
Practice Address - Phone:216-835-5986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker