Provider Demographics
NPI:1023887262
Name:HALL, NORA (BA)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 FLORAL SPRINGS BLVD UNIT 24211
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129-6839
Mailing Address - Country:US
Mailing Address - Phone:386-286-8424
Mailing Address - Fax:
Practice Address - Street 1:1200 FLORAL SPRINGS BLVD UNIT 24211
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32129-6839
Practice Address - Country:US
Practice Address - Phone:386-286-8424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
FLH4062993558171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator