Individual
MARY ALICE HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN0000158536
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
14352
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
892560
CRNA
MS
01
—
RN0000158536
RN LICENSE
TN
Enumeration date
06/24/2009
Last updated
03/17/2018
Update your record
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