Provider Demographics
NPI:1770746430
Name:HALL, SUANN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SUANN
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:BELL BUCKLE
Mailing Address - State:TN
Mailing Address - Zip Code:37020-0190
Mailing Address - Country:US
Mailing Address - Phone:240-427-7881
Mailing Address - Fax:
Practice Address - Street 1:1802 N JACKSON ST STE 850
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-8237
Practice Address - Country:US
Practice Address - Phone:931-563-5501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0097165-NP363LF0000X
PASP012015363LF0000X
NC5009761363LF0000X, 363L00000X
TN33505363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1770746430OtherNPI