Provider Demographics
NPI:1366448011
Name:HALL, LOIS HARTMAN (CRNP)
Entity Type:Individual
Prefix:MS
First Name:LOIS
Middle Name:HARTMAN
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:PO BOX 13579
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19612-3579
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3200 READING CREST AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-1656
Practice Address - Country:US
Practice Address - Phone:610-921-2366
Practice Address - Fax:610-929-5138
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007588363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA067453OtherMEDICARE
PA0102163895Medicaid
PAP81500Medicare UPIN