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Individual

MRS. VIRGINIA A HALLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
1115 LEXINGTON AVE, SAVANNAH, GA 31404-5502
(912) 354-4813
(912) 354-7569
Mailing address
PO BOX 15238, SAVANNAH, GA 31416-1938
(912) 354-4813
(912) 354-7569

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
R00079381
SC
363LA2200X
Adult Health Nurse Practitioner
Primary
R039856
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00929255A
GA
05
NP0564
SC
Enumeration date
06/02/2005
Last updated
08/07/2014
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