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Individual

NANCY KRISTINE HALLER

Active
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Individual

NANCY KRISTINE HALLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
GCFP NCMMT LMP MA

Taxonomy

Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
GCFP1653
OR
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
1653
OR
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
MA00008877
WA
225700000X
Massage Therapist
Primary
MA00008877
WA
225700000X
Massage Therapist
NCMMT0019
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0005102596
AETNA
01
0151472
LABOR AND INDUSTRIES
01
146525495
PACIFICCARE
01
341120341120
PREMERA
01
533829001
GROUP HEALTH COOPERATIVE
01
912120516
HMA
01
91212051600
UNIFORM
01
HA4253
REGENCE
Enumeration date
11/01/2006
Last updated
03/31/2023
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