Provider Demographics
NPI:1801480538
Name:HALES, VON (RN)
Entity type:Individual
Prefix:
First Name:VON
Middle Name:
Last Name:HALES
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3356 SHALLOWFORD CIR
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-4487
Mailing Address - Country:US
Mailing Address - Phone:205-542-0543
Mailing Address - Fax:
Practice Address - Street 1:3356 SHALLOWFORD CIR
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-4487
Practice Address - Country:US
Practice Address - Phone:205-542-0543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1157701251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care