Provider Demographics
NPI:1457466229
Name:HALL, JEANNE LOUISE (FNP)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:LOUISE
Last Name:HALL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7405 PIONEERS BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-7554
Mailing Address - Country:US
Mailing Address - Phone:531-500-2982
Mailing Address - Fax:531-500-4736
Practice Address - Street 1:7405 PIONEERS BLVD STE 4
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506
Practice Address - Country:US
Practice Address - Phone:531-500-2982
Practice Address - Fax:531-500-4736
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45084363L00000X
WAAP60338784363L00000X, 363LF0000X
NE112751363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS111246OtherBC/BS SPEARVILLE