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Individual
TIMOTHY WAYNE HALL
Active
Individual
TIMOTHY WAYNE HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC, FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
4704199433
MI
363LF0000X
Family Nurse Practitioner
Primary
4704199433
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154761336
—
MI
Enumeration date
07/02/2013
Last updated
03/07/2023
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