Individual
MARY HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
16901 LAKESIDE HILLS CT, ATTN: HOSPITAL MEDICINE, OMAHA, NE 68130-2318
(855) 524-4001
(402) 717-7340
Mailing address
7261 MERCY RD, OMAHA, NE 68124-2311
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
081276
IA
363A00000X
Physician Assistant
Primary
2002
NE
Other
Enumeration date
02/23/2016
Last updated
09/21/2016
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