Provider Demographics
NPI:1851508915
Name:HALLUM, NINA LOU (ARNP)
Entity Type:Individual
Prefix:MS
First Name:NINA
Middle Name:LOU
Last Name:HALLUM
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:NINA
Other - Middle Name:ROBISON
Other - Last Name:HALLUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:9935 STATE HIGHWAY 28
Mailing Address - Street 2:
Mailing Address - City:EUCHA
Mailing Address - State:OK
Mailing Address - Zip Code:74342-4033
Mailing Address - Country:US
Mailing Address - Phone:918-253-3479
Mailing Address - Fax:
Practice Address - Street 1:433 SOUTH 9TH STREET
Practice Address - Street 2:
Practice Address - City:JAY
Practice Address - State:OK
Practice Address - Zip Code:74346
Practice Address - Country:US
Practice Address - Phone:918-253-4511
Practice Address - Fax:918-253-8419
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0046086163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory