Provider Demographics
NPI:1942810601
Name:HALL, REBECCA (PA)
Entity Type:Individual
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First Name:REBECCA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:5117 SUNMORE CIR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-5124
Mailing Address - Country:US
Mailing Address - Phone:432-689-2512
Mailing Address - Fax:432-689-2108
Practice Address - Street 1:5117 SUNMORE CIR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-5124
Practice Address - Country:US
Practice Address - Phone:432-689-2512
Practice Address - Fax:432-689-2108
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2022-11-01
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant