Provider Demographics
NPI:1184484834
Name:HALL, ROBERT L JR (MSN, APRN, AGPCNP-BC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:L
Last Name:HALL
Suffix:JR
Gender:M
Credentials:MSN, APRN, AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6561 AUTUMN WOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-7801
Mailing Address - Country:US
Mailing Address - Phone:239-248-2527
Mailing Address - Fax:
Practice Address - Street 1:6561 AUTUMN WOODS BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-7801
Practice Address - Country:US
Practice Address - Phone:239-248-2527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11031599363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care