Individual
MARY ALICE HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9140 HIGHWAY 51 N # SOUTH, SOUTHAVEN, MS 38671-1233
(662) 280-8222
(662) 280-5541
Mailing address
3340 PLAYERS CLUB PKWY STE 350, MEMPHIS, TN 38125-8949
(901) 844-1590
(844) 752-2159
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
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