Provider Demographics
NPI:1881654861
Name:HALL, MICHELLE LYNN (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LYNN
Last Name:HALL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MISS
Other - First Name:MICHELLE
Other - Middle Name:LYNN
Other - Last Name:LEMANSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHRAM D
Mailing Address - Street 1:10701 E 37TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-6834
Mailing Address - Country:US
Mailing Address - Phone:928-305-9931
Mailing Address - Fax:
Practice Address - Street 1:115 N SOMERTON AVE
Practice Address - Street 2:
Practice Address - City:SOMERTON
Practice Address - State:AZ
Practice Address - Zip Code:85350
Practice Address - Country:US
Practice Address - Phone:928-627-1607
Practice Address - Fax:928-627-1673
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14213183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist