Provider Demographics
NPI:1821372350
Name:HALL, HARRIETT SPENCER (RN)
Entity Type:Individual
Prefix:MRS
First Name:HARRIETT
Middle Name:SPENCER
Last Name:HALL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 AGAWAM ST
Mailing Address - Street 2:
Mailing Address - City:NORTH EAST
Mailing Address - State:PA
Mailing Address - Zip Code:16428-1402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:82 AGAWAM ST
Practice Address - Street 2:
Practice Address - City:NORTH EAST
Practice Address - State:PA
Practice Address - Zip Code:16428-1402
Practice Address - Country:US
Practice Address - Phone:814-725-5786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN278000L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse