Provider Demographics
NPI:1558865311
Name:HALL, MICHELLE LYNN (CRNP)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:LYNN
Last Name:HALL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:695 E 16TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:BERWICK
Mailing Address - State:PA
Mailing Address - Zip Code:18603-2320
Mailing Address - Country:US
Mailing Address - Phone:570-752-3640
Mailing Address - Fax:570-752-3425
Practice Address - Street 1:695 E 16TH ST STE B
Practice Address - Street 2:
Practice Address - City:BERWICK
Practice Address - State:PA
Practice Address - Zip Code:18603-2320
Practice Address - Country:US
Practice Address - Phone:570-752-3640
Practice Address - Fax:570-752-3425
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAF03180251207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine