Provider Demographics
NPI:1629718481
Name:HALL, LINDA R (HHA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:R
Last Name:HALL
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 W 21ST ST
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-4607
Mailing Address - Country:US
Mailing Address - Phone:440-453-0349
Mailing Address - Fax:
Practice Address - Street 1:1109 W 21ST ST
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-4607
Practice Address - Country:US
Practice Address - Phone:440-453-0349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHUK400000374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty