Provider Demographics
NPI:1598327264
Name:HALL-MCFADDEN, JERI LYNN
Entity Type:Individual
Prefix:MRS
First Name:JERI
Middle Name:LYNN
Last Name:HALL-MCFADDEN
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 1:4373 MARJORIE RD
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-6538
Mailing Address - Country:US
Mailing Address - Phone:770-860-1815
Mailing Address - Fax:
Practice Address - Street 1:4373 MARJORIE RD
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-6538
Practice Address - Country:US
Practice Address - Phone:404-624-6151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer