Provider Demographics
NPI:1699474577
Name:HALL, DENISE D
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:D
Last Name:HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22300 HARMS RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1624
Mailing Address - Country:US
Mailing Address - Phone:216-262-4176
Mailing Address - Fax:
Practice Address - Street 1:22300 HARMS RD
Practice Address - Street 2:
Practice Address - City:RICHMOND HTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1624
Practice Address - Country:US
Practice Address - Phone:216-262-4176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376J00000X
OH123453747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant