Provider Demographics
NPI:1134520018
Name:HALL, CHRISTOPHER TIMOTHY (APRN, RNFA)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:TIMOTHY
Last Name:HALL
Suffix:
Gender:M
Credentials:APRN, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 PRINGLE WAY STE 1002
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1475
Mailing Address - Country:US
Mailing Address - Phone:775-323-7500
Mailing Address - Fax:775-789-9208
Practice Address - Street 1:3237 SUSILEEN DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3859
Practice Address - Country:US
Practice Address - Phone:775-313-7779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-10
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN60561163WR0006X
NVAPRN002618363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1134520018Medicaid
NVCEP11471OtherRNFA PROVIDER NUMBER
NVRN60561OtherREGISTERED NURSE
NVAPRN002618OtherADVANCED PRACTICE REGISTERED NURSE