Individual
HOLLY E HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
209 9TH ST, ROCKFORD, IL 61104-2235
(779) 696-2750
Mailing address
209 9TH ST, ROCKFORD, IL 61104-2235
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209026044
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209026044
NP LICENSE
IL
Enumeration date
11/14/2022
Last updated
11/14/2022
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