Individual
MRS. LISA J HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1950 GLENN MITCHELL, SUITE 102, VIRGINIA BEACH, VA 23456-0019
(757) 368-0437
(757) 368-0492
Mailing address
5900 LAKE WRIGHT DR, SUITE 300, NORFOLK, VA 23502-1871
(757) 213-5700
(757) 213-5701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0101029566
VA
363A00000X
Physician Assistant
Primary
0110002089
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10019259P
OPTIMA
VA
Enumeration date
07/07/2005
Last updated
06/16/2009
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