Provider Demographics
NPI:1821147695
Name:HALL, KRISTIN JILL (RPH)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:JILL
Last Name:HALL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2931 DEER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-9255
Mailing Address - Country:US
Mailing Address - Phone:940-642-3065
Mailing Address - Fax:
Practice Address - Street 1:1417 E INTERSTATE 30
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-4786
Practice Address - Country:US
Practice Address - Phone:972-303-5462
Practice Address - Fax:972-303-5470
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32029183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist