Individual
MRS. WHITNEY J HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
139 W HIGHWAY 32, LICKING, MO 65542-9898
(573) 674-3011
(573) 674-4765
Mailing address
139 W HIGHWAY 32, LICKING, MO 65542-9898
(573) 674-3011
(573) 674-4765
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2014027661
MO
363A00000X
Physician Assistant
Primary
2014031392
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220024367
—
MO
01
—
26D0679044
CLIA
MO
Enumeration date
08/13/2014
Last updated
09/04/2025
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