Provider Demographics
NPI:1255619557
Name:HALL, CYNTHIA ELLEN (RPA)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ELLEN
Last Name:HALL
Suffix:
Gender:F
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 SUNSET DRIVE
Mailing Address - Street 2:SUITE #3
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604
Mailing Address - Country:US
Mailing Address - Phone:423-926-4966
Mailing Address - Fax:423-979-5657
Practice Address - Street 1:1301 SUNSET DRIVE
Practice Address - Street 2:SUITE #3
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604
Practice Address - Country:US
Practice Address - Phone:423-926-4966
Practice Address - Fax:423-979-5657
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRA0000000007243U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant