Individual
MS. TRACEY M HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 EATON PL, ST. VINCENT HOSPTIAL BREAST CARE PROGRAM ONE, WORCESTER, MA 01608-1232
(508) 363-6881
(508) 363-7591
Mailing address
1 EATON PL, STE 23, WORCESTER, MA 01608-1232
(508) 363-6881
(508) 363-7591
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
254657
MA
363L00000X
Nurse Practitioner
4704256710
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0398756
—
MA
Enumeration date
03/14/2006
Last updated
11/05/2014
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