Provider Demographics
NPI:1891011508
Name:HALL, TIFFANI H (BSN)
Entity Type:Individual
Prefix:
First Name:TIFFANI
Middle Name:H
Last Name:HALL
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLER BOX C-268
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE
Mailing Address - State:NC
Mailing Address - Zip Code:28719-9999
Mailing Address - Country:US
Mailing Address - Phone:828-497-9163
Mailing Address - Fax:
Practice Address - Street 1:328 OLD AIRPORT RD
Practice Address - Street 2:
Practice Address - City:MARBLE
Practice Address - State:NC
Practice Address - Zip Code:28905
Practice Address - Country:US
Practice Address - Phone:828-497-9163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC161592163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC161592OtherNC RN