Provider Demographics
NPI:1720264872
Name:HALL-ALSTON, JANE MARIE (APRN,BC,ANP)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:MARIE
Last Name:HALL-ALSTON
Suffix:
Gender:F
Credentials:APRN,BC,ANP
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:10202 AVENUE RD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-2806
Mailing Address - Country:US
Mailing Address - Phone:440-351-9118
Mailing Address - Fax:904-479-9575
Practice Address - Street 1:300 E OVERLOOK
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-4730
Practice Address - Country:US
Practice Address - Phone:516-220-0284
Practice Address - Fax:718-224-0694
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF302659-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner