Provider Demographics
NPI:1851085112
Name:ANDERSON, HALLIE MORGAN (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:HALLIE
Middle Name:MORGAN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1587 E 31ST ST APT 117
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-4353
Mailing Address - Country:US
Mailing Address - Phone:440-313-8759
Mailing Address - Fax:
Practice Address - Street 1:6300 BROOKPARK RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44129-1219
Practice Address - Country:US
Practice Address - Phone:404-672-6955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0033929363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily