Provider Demographics
NPI:1972856227
Name:HALE, JUANITA
Entity Type:Individual
Prefix:MISS
First Name:JUANITA
Middle Name:
Last Name:HALE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:NITA
Other - Middle Name:
Other - Last Name:HALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN
Mailing Address - Street 1:837 CELIA LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2305
Mailing Address - Country:US
Mailing Address - Phone:859-321-8631
Mailing Address - Fax:
Practice Address - Street 1:8 LINVILLE DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-2128
Practice Address - Country:US
Practice Address - Phone:859-321-8631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1075442163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult