Provider Demographics
NPI:1710984182
Name:HALL, DONNA ALLISON (FNP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:ALLISON
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 1:121 HIGHWAY 76
Mailing Address - Street 2:
Mailing Address - City:WHITE HOUSE
Mailing Address - State:TN
Mailing Address - Zip Code:37188-9292
Mailing Address - Country:US
Mailing Address - Phone:615-672-5575
Mailing Address - Fax:615-672-5405
Practice Address - Street 1:121 HIGHWAY 76
Practice Address - Street 2:
Practice Address - City:WHITE HOUSE
Practice Address - State:TN
Practice Address - Zip Code:37188-9292
Practice Address - Country:US
Practice Address - Phone:615-672-5575
Practice Address - Fax:615-672-5405
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN6177363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3346365Medicaid
TN3346366Medicare ID - Type Unspecified
TN3346365Medicaid