Provider Demographics
NPI:1700226040
Name:HALL, NAKEDA LASHON (APRN-CNP)
Entity type:Individual
Prefix:MRS
First Name:NAKEDA
Middle Name:LASHON
Last Name:HALL
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 BISCAYNE LN
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:OK
Mailing Address - Zip Code:73538-5005
Mailing Address - Country:US
Mailing Address - Phone:580-284-5058
Mailing Address - Fax:
Practice Address - Street 1:110 NW 31ST ST STE 201
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6100
Practice Address - Country:US
Practice Address - Phone:580-585-5549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0087087363LP0808X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health