Individual
JILL HALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
565 ABBOTT RD, BUFFALO, NY 14220-2039
(716) 480-5909
Mailing address
231 W FALLS RD, WEST FALLS, NY 14170-9727
(716) 480-5909
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
000000
NY
Other
Enumeration date
08/06/2014
Last updated
10/09/2018
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