Provider Demographics
NPI:1316691991
Name:HALL, JESSICA DAWN (RN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:DAWN
Last Name:HALL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 STRATHWICK LN
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-4097
Mailing Address - Country:US
Mailing Address - Phone:740-417-6197
Mailing Address - Fax:
Practice Address - Street 1:124 STRATHWICK LN
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-4097
Practice Address - Country:US
Practice Address - Phone:740-417-6197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.409674163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management