Provider Demographics
NPI:1972887453
Name:HALL-MOTEN, ELIZABETH RUTH (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:RUTH
Last Name:HALL-MOTEN
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:RUTH
Other - Last Name:MONTGOMERY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:9009 N FM 620
Mailing Address - Street 2:STE 1313
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78726-4200
Mailing Address - Country:US
Mailing Address - Phone:512-367-9049
Mailing Address - Fax:512-551-2096
Practice Address - Street 1:9009 NORTH FM 620
Practice Address - Street 2:STE 1313
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78726-4200
Practice Address - Country:US
Practice Address - Phone:512-367-9049
Practice Address - Fax:512-551-2096
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-03
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX758363163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health