Provider Demographics
NPI:1023004736
Name:HALL, DENELLE LYNN (RPH)
Entity type:Individual
Prefix:MS
First Name:DENELLE
Middle Name:LYNN
Last Name:HALL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6158 PALMA DEL MAR BLVD S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33715-1222
Mailing Address - Country:US
Mailing Address - Phone:941-721-0649
Mailing Address - Fax:
Practice Address - Street 1:6158 PALMA DEL MAR BLVD S
Practice Address - Street 2:201B
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33715-1295
Practice Address - Country:US
Practice Address - Phone:941-721-0649
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 334551835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy