Provider Demographics
NPI:1265047807
Name:HALE, CARRIE MORGAN
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:MORGAN
Last Name:HALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12003 S CLAY RD
Mailing Address - Street 2:
Mailing Address - City:DELPHOS
Mailing Address - State:OH
Mailing Address - Zip Code:45833-9235
Mailing Address - Country:US
Mailing Address - Phone:419-348-5496
Mailing Address - Fax:
Practice Address - Street 1:12003 S CLAY RD
Practice Address - Street 2:
Practice Address - City:DELPHOS
Practice Address - State:OH
Practice Address - Zip Code:45833-9235
Practice Address - Country:US
Practice Address - Phone:419-348-5496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care