Provider Demographics
NPI:1891074282
Name:HALL, TERRI LYNN (APRN)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:LYNN
Last Name:HALL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 N MAYO TRL
Mailing Address - Street 2:STE 3
Mailing Address - City:PAINTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41240-1811
Mailing Address - Country:US
Mailing Address - Phone:606-886-7480
Mailing Address - Fax:606-886-7573
Practice Address - Street 1:113 FRANK ST
Practice Address - Street 2:
Practice Address - City:STAFFORDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41256-9098
Practice Address - Country:US
Practice Address - Phone:606-886-7480
Practice Address - Fax:606-886-7573
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007069363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily