Individual
MRS. KATHERINE BROOKE HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1125 E POLSTON AVE STE B, POST FALLS, ID 83854-6045
(208) 758-0075
(208) 758-0076
Mailing address
70 MEDICAL CENTER CIR, SUITE 301, FISHERSVILLE, VA 22939-2273
(540) 448-8819
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA10005306
WA
363A00000X
Physician Assistant
Primary
PA1846
ID
363AM0700X
Medical Physician Assistant
0110002075
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010235421
—
VA
Enumeration date
05/24/2006
Last updated
08/17/2020
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