Provider Demographics
NPI:1699357434
Name:HALL, CHRISTOPHER BENJAMIN (APRN, MSN, FNP-C)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:BENJAMIN
Last Name:HALL
Suffix:
Gender:M
Credentials:APRN, MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 TRUXEL RD APT 328
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-3733
Mailing Address - Country:US
Mailing Address - Phone:209-423-0274
Mailing Address - Fax:
Practice Address - Street 1:5959 GREENBACK LN STE 500
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-4700
Practice Address - Country:US
Practice Address - Phone:916-737-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95014605363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care