| NPI | 1134678972 |
|---|---|
| Former Name | CARLY ELIZABETH HALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-138869) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: AL 1-138869) |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 201605978NP-PP) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: AL 1-138869) | |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2022-09-08 |