Provider Demographics
NPI:1831396985
Name:HALL, MICHELLE D (FNP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:D
Last Name:HALL
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 US HIGHWAY 158 W
Mailing Address - Street 2:
Mailing Address - City:YANCEYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27379-8304
Mailing Address - Country:US
Mailing Address - Phone:336-694-9331
Mailing Address - Fax:336-694-7511
Practice Address - Street 1:133 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-4071
Practice Address - Country:US
Practice Address - Phone:434-792-2907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC170580363LF0000X
VA0024166710363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0017138446OtherFNP AUTH TO PRESC- VA
NC201926OtherAPPROVAL TO PRACTICE AS A NURSE PRACTITIONER
VA0024166710OtherFNP LICENSE - VA
MM1148065OtherDEA NUMBER