Provider Demographics
NPI:1134365513
Name:GARLAND, HALLIE LYNN (RN, CDE)
Entity type:Individual
Prefix:
First Name:HALLIE
Middle Name:LYNN
Last Name:GARLAND
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 PARK ST
Mailing Address - Street 2:ALICE HYDE MEDICAL CENTER
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-1243
Mailing Address - Country:US
Mailing Address - Phone:518-481-2427
Mailing Address - Fax:518-481-2695
Practice Address - Street 1:133 PARK ST
Practice Address - Street 2:ALICE HYDE MEDICAL CENTER
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1243
Practice Address - Country:US
Practice Address - Phone:518-481-2427
Practice Address - Fax:518-481-2695
Is Sole Proprietor?:No
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22-399676163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse