Individual
SHAWN HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1400 E DOWNING ST, TAHLEQUAH, OK 74464-3324
(918) 453-2101
(918) 453-2103
Mailing address
1009 CALLIE AVE, TAHLEQUAH, OK 74464-7003
(918) 525-2644
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
105693
OK
363LA2100X
Acute Care Nurse Practitioner
Primary
105693
OK
Other
Enumeration date
09/09/2019
Last updated
04/16/2025
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