Provider Demographics
NPI:1841704996
Name:HALL, BRITTANY L
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:L
Last Name:HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:L
Other - Last Name:BRIDGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3000 COLUMBINE CIR APT C
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-0975
Mailing Address - Country:US
Mailing Address - Phone:219-789-5592
Mailing Address - Fax:
Practice Address - Street 1:1500 S LAKE PARK AVE STE 310
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-6638
Practice Address - Country:US
Practice Address - Phone:219-762-0400
Practice Address - Fax:219-762-2460
Is Sole Proprietor?:No
Enumeration Date:2017-11-28
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71007718A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner