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Individual

MRS. THERESA GALE HALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
2490 S WOODWORTH LOOP STE 250, PALMER, AK 99645-7407
(907) 861-6700
Mailing address
2490 S WOODWORTH LOOP STE 250, PALMER, AK 99645-7407
(907) 861-6700

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
132563
AK
363LG0600X
Gerontology Nurse Practitioner
3010502
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1685772
AK
Enumeration date
10/26/2016
Last updated
01/16/2025
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