Provider Demographics
NPI:1801952932
Name:HALL, J. KATHLEEN (DEM)
Entity type:Individual
Prefix:MS
First Name:J.
Middle Name:KATHLEEN
Last Name:HALL
Suffix:
Gender:F
Credentials:DEM
Other - Prefix:MS
Other - First Name:J.
Other - Middle Name:KATHLEEN
Other - Last Name:PRESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LM
Mailing Address - Street 1:2021 9TH AVE N
Mailing Address - Street 2:APT. B
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-0311
Mailing Address - Country:US
Mailing Address - Phone:406-672-7029
Mailing Address - Fax:
Practice Address - Street 1:2021 9TH AVE N
Practice Address - Street 2:APT. B
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0311
Practice Address - Country:US
Practice Address - Phone:406-672-7029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT14175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000099013Medicare UPIN