Individual
STACEY JACKSON HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2222 S PARK ST STE 210, MADISON, WI 53713-2168
(608) 251-6546
Mailing address
2222 S PARK ST STE 210, MADISON, WI 53713-2168
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
9309665
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014712900
—
FL
Enumeration date
06/04/2013
Last updated
11/29/2022
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