Individual
MS. JAMIE DERESA HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F. N.P., G.N.P.
Contact information
Practice address
340 BAGLEY CIRCLE, SOUTHWESTERN VIRGINIA MENTAL HEALTH INSTITUTE, MARION, VA 24354-9998
(276) 783-1200
Mailing address
340 BAGLEY CIRCLE, SOUTHWESTERN VIRGINIA MENTAL HEALTH INSTITUTE, MARION, VA 24354
(276) 783-1200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0001073929
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010261546
—
VA
Enumeration date
05/17/2006
Last updated
12/11/2009
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