Individual
TAMARA C HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN ACNP
Contact information
Practice address
86 HARRIS DR., KILMARNOCK, VA 22482
(804) 435-2651
Mailing address
PO BOX 535, BURGESS, VA 22432-0535
(804) 453-7517
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
0024165987
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024165987
NP LICENSE
VA
01
—
P00480084
RR MEDICARE
VA
Enumeration date
12/11/2006
Last updated
07/23/2025
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