Provider Demographics
NPI:1184890501
Name:HALL, CHRISTY M (BS)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:M
Last Name:HALL
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10731 N STATE ROAD 13
Mailing Address - Street 2:
Mailing Address - City:ELWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46036-8874
Mailing Address - Country:US
Mailing Address - Phone:765-552-5009
Mailing Address - Fax:765-552-8347
Practice Address - Street 1:10731 N STATE ROAD 13
Practice Address - Street 2:
Practice Address - City:ELWOOD
Practice Address - State:IN
Practice Address - Zip Code:46036-8874
Practice Address - Country:US
Practice Address - Phone:765-552-5009
Practice Address - Fax:765-552-8347
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator