Provider Demographics
NPI:1255756326
Name:HALL, SARAH NUNN (CPNP-PC APRN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:NUNN
Last Name:HALL
Suffix:
Gender:F
Credentials:CPNP-PC APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 SOUTHERN OAKS LN
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-2462
Mailing Address - Country:US
Mailing Address - Phone:706-267-3950
Mailing Address - Fax:
Practice Address - Street 1:1 HAVENWOOD LN
Practice Address - Street 2:
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690-9447
Practice Address - Country:US
Practice Address - Phone:864-834-8013
Practice Address - Fax:864-834-6977
Is Sole Proprietor?:No
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18573363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics