Individual
MICHELLE R HALLSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
89 BEAVER DR, DU BOIS, PA 15801-2425
(814) 371-4524
(814) 371-0331
Mailing address
89 BEAVER DR, DU BOIS, PA 15801-2425
(814) 371-4524
(814) 371-0331
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP010892
PA
Other
Enumeration date
09/14/2010
Last updated
09/14/2010
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