Provider Demographics
NPI:1811798002
Name:HALL, TIFFANY NYCOLE (PERSONAL CARE, CD)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:NYCOLE
Last Name:HALL
Suffix:
Gender:
Credentials:PERSONAL CARE, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1297 NUCKOLDS RD
Mailing Address - Street 2:
Mailing Address - City:HUDDLESTON
Mailing Address - State:VA
Mailing Address - Zip Code:24104-3530
Mailing Address - Country:US
Mailing Address - Phone:434-363-6701
Mailing Address - Fax:
Practice Address - Street 1:1297 NUCKOLDS RD
Practice Address - Street 2:
Practice Address - City:HUDDLESTON
Practice Address - State:VA
Practice Address - Zip Code:24104-3530
Practice Address - Country:US
Practice Address - Phone:434-363-6701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant