Provider Demographics
NPI:1942428149
Name:HALL, TERESA KAY (LPN)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:KAY
Last Name:HALL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:591 COUNTY ROAD 53
Mailing Address - Street 2:
Mailing Address - City:KITTS HILL
Mailing Address - State:OH
Mailing Address - Zip Code:45645-8921
Mailing Address - Country:US
Mailing Address - Phone:740-534-0131
Mailing Address - Fax:740-534-0131
Practice Address - Street 1:591 COUNTY ROAD 53
Practice Address - Street 2:
Practice Address - City:KITTS HILL
Practice Address - State:OH
Practice Address - Zip Code:45645-8921
Practice Address - Country:US
Practice Address - Phone:740-534-0131
Practice Address - Fax:740-534-0131
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN103282164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse