Provider Demographics
NPI:1841449428
Name:HALL, MARY M (RNC NNP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:M
Last Name:HALL
Suffix:
Gender:F
Credentials:RNC NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2707 WOODRIDGE MANOR DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-2753
Mailing Address - Country:US
Mailing Address - Phone:832-865-2942
Mailing Address - Fax:
Practice Address - Street 1:10655 STEEPLETOP DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4222
Practice Address - Country:US
Practice Address - Phone:281-897-3516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX465414363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care