Provider Demographics
NPI:1881164259
Name:HALL, PENNY JONES
Entity type:Individual
Prefix:
First Name:PENNY
Middle Name:JONES
Last Name:HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 VAN ARPEL DR
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-6341
Mailing Address - Country:US
Mailing Address - Phone:985-652-5345
Mailing Address - Fax:
Practice Address - Street 1:2200 VAN ARPEL DR
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-6341
Practice Address - Country:US
Practice Address - Phone:985-652-5345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-28
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator