Provider Demographics
NPI:1285971366
Name:HURT HALL, BRIDGET DIANA (FNP)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:DIANA
Last Name:HURT HALL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8810 E RIDGE TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:SODDY DAISY
Mailing Address - State:TN
Mailing Address - Zip Code:37379-3460
Mailing Address - Country:US
Mailing Address - Phone:423-802-5169
Mailing Address - Fax:
Practice Address - Street 1:2200 E 3RD ST STE 200
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-2745
Practice Address - Country:US
Practice Address - Phone:423-643-2500
Practice Address - Fax:423-305-7822
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19547363LF0000X
TNAPN19547363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily