Provider Demographics
NPI:1437258076
Name:HALL, JANETTA QUIN (RN)
Entity Type:Individual
Prefix:MRS
First Name:JANETTA
Middle Name:QUIN
Last Name:HALL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:797 POINTE WEST LOOP
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-0912
Mailing Address - Country:US
Mailing Address - Phone:478-275-2673
Mailing Address - Fax:
Practice Address - Street 1:797 POINTE WEST LOOP
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-0912
Practice Address - Country:US
Practice Address - Phone:478-275-2673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA076967163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse