Provider Demographics
NPI:1588915664
Name:HALL, GLORIA ANN (NP-C)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:ANN
Last Name:HALL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1450 JONES DAIRY RD
Mailing Address - Street 2:BLDG 700
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-6106
Mailing Address - Country:US
Mailing Address - Phone:205-295-4200
Mailing Address - Fax:205-295-4201
Practice Address - Street 1:1450 JONES DAIRY RD
Practice Address - Street 2:BLDG 700
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-6106
Practice Address - Country:US
Practice Address - Phone:205-295-4200
Practice Address - Fax:205-295-4201
Is Sole Proprietor?:No
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-069714363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care