Provider Demographics
NPI:1952703241
Name:HALL, AARON (CRNA)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:
Last Name:HALL
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 W LAKEWAY RD STE 3
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82718-6373
Mailing Address - Country:US
Mailing Address - Phone:307-686-7028
Mailing Address - Fax:307-685-8027
Practice Address - Street 1:3100 W LAKEWAY RD STE 3
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82718-6373
Practice Address - Country:US
Practice Address - Phone:307-687-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY34418.1356367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered