Provider Demographics
NPI:1467807446
Name:HALL, CHRISTINE CAROL
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:CAROL
Last Name:HALL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-2626
Mailing Address - Country:US
Mailing Address - Phone:660-543-4770
Mailing Address - Fax:
Practice Address - Street 1:600 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-2626
Practice Address - Country:US
Practice Address - Phone:660-543-4770
Practice Address - Fax:660-543-8222
Is Sole Proprietor?:No
Enumeration Date:2016-04-27
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016021950363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily