Provider Demographics
NPI:1851036032
Name:HALL, ANDREA STARR (NP)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:STARR
Last Name:HALL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:482 INTERSTATE DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-3485
Mailing Address - Country:US
Mailing Address - Phone:931-444-1000
Mailing Address - Fax:931-728-1229
Practice Address - Street 1:482 INTERSTATE DR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-3485
Practice Address - Country:US
Practice Address - Phone:931-444-1000
Practice Address - Fax:931-728-1229
Is Sole Proprietor?:No
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN31638363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily