Provider Demographics
NPI:1679046320
Name:HALL, CONSTANCE MARIE (FNP-C)
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:MARIE
Last Name:HALL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 IVEY LANE
Mailing Address - Street 2:SUITE B
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-9817
Mailing Address - Country:US
Mailing Address - Phone:910-215-5210
Mailing Address - Fax:910-215-5215
Practice Address - Street 1:150 IVEY LANE
Practice Address - Street 2:SUITE B
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-9817
Practice Address - Country:US
Practice Address - Phone:910-215-5210
Practice Address - Fax:910-215-5215
Is Sole Proprietor?:No
Enumeration Date:2019-01-05
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013908363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty