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Individual

BETHANY S HALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
44201 DEQUINDRE RD, TROY, MI 48085-1117
(248) 964-5000
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1952
(947) 522-0307

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3006569
KY
363L00000X
Nurse Practitioner
Primary
4704290976
MI
363LF0000X
Family Nurse Practitioner
3006569
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201000330
IN
05
7100132120
KY
Enumeration date
06/14/2010
Last updated
02/03/2022
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