Provider Demographics
NPI:1437903929
Name:HALL, TINA
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 N MEDINA ST APT 1
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-1891
Mailing Address - Country:US
Mailing Address - Phone:330-573-8236
Mailing Address - Fax:
Practice Address - Street 1:248 N MEDINA ST APT 1
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-1891
Practice Address - Country:US
Practice Address - Phone:330-573-8236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No172A00000XOther Service ProvidersDriver
No376J00000XNursing Service Related ProvidersHomemaker