Individual
MS. JACQUELYN MARIE HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
19 E OAK ST, WEST ALEXANDRIA, OH 45381-1221
(937) 839-4736
Mailing address
19 E OAK ST, WEST ALEXANDRIA, OH 45381-1221
(937) 839-4736
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN079494
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2128012
—
OH
01
—
27039654A
LPN
IN
Enumeration date
04/18/2007
Last updated
07/09/2007
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