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Individual

ASHLEY NICOLE HALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3444 PLAZA AVE, MEMPHIS, TN 38111-4614
(901) 730-4204
Mailing address
829 MERRYWOOD GLN APT 2, MEMPHIS, TN 38117-5011
(901) 210-3283

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3482
TN
363A00000X
Physician Assistant
9112804
FL
363A00000X
Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q034093
TN
Enumeration date
10/09/2017
Last updated
01/30/2020
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