Provider Demographics
NPI:1245954858
Name:HALL, MALLORIE LOU MORTON (CNM, IBCLC)
Entity type:Individual
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First Name:MALLORIE
Middle Name:LOU MORTON
Last Name:HALL
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Gender:F
Credentials:CNM, IBCLC
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Mailing Address - Street 1:411 N WASHINGTON AVE STE 2700
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1735
Mailing Address - Country:US
Mailing Address - Phone:214-975-3937
Mailing Address - Fax:469-309-7787
Practice Address - Street 1:411 N WASHINGTON AVE STE 2700
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1735
Practice Address - Country:US
Practice Address - Phone:214-975-3937
Practice Address - Fax:469-309-7787
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2023-06-11
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife