Provider Demographics
NPI:1649362336
Name:HALL, PATRICIA KAY (APRN,BC)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:KAY
Last Name:HALL
Suffix:
Gender:F
Credentials:APRN,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1719 GROTON DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-1221
Mailing Address - Country:US
Mailing Address - Phone:330-650-0667
Mailing Address - Fax:
Practice Address - Street 1:55 W WATERLOO RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44319-1116
Practice Address - Country:US
Practice Address - Phone:330-724-7715
Practice Address - Fax:330-724-1029
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN141220364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult