Provider Demographics
NPI:1922771252
Name:HALL, RAQUEL TANZSWA (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:TANZSWA
Last Name:HALL
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
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Other - Middle Name:
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Mailing Address - Street 1:238 BROOKLEY AVE SW BLDG 1300
Mailing Address - Street 2:
Mailing Address - City:BOLLING AFB
Mailing Address - State:DC
Mailing Address - Zip Code:20032-7704
Mailing Address - Country:US
Mailing Address - Phone:202-767-7839
Mailing Address - Fax:
Practice Address - Street 1:238 BROOKLEY AVE SW BLDG 1300
Practice Address - Street 2:
Practice Address - City:BOLLING AFB
Practice Address - State:DC
Practice Address - Zip Code:20032-7704
Practice Address - Country:US
Practice Address - Phone:202-404-3906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2024-02-06
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant