Provider Demographics
NPI:1457951063
Name:HALL, COURTNEY (CNA)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3223 SPRING HILL AVE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-1809
Mailing Address - Country:US
Mailing Address - Phone:251-487-5056
Mailing Address - Fax:
Practice Address - Street 1:3223 SPRING HILL AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-1809
Practice Address - Country:US
Practice Address - Phone:251-487-5056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-01
Last Update Date:2020-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide