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Individual
TINA HALL
Active
Individual
TINA HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.394076
IL
207N00000X
Dermatology Physician
209018461
IL
363L00000X
Nurse Practitioner
209018461
IL
363LF0000X
Family Nurse Practitioner
Primary
209.018461
IL
Other
Enumeration date
10/15/2018
Last updated
11/07/2019
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