Provider Demographics
NPI:1992792477
Name:HALL, JENNIFER DENISE (RN)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:DENISE
Last Name:HALL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3422 PRYOR RD
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MS
Mailing Address - Zip Code:38618-7742
Mailing Address - Country:US
Mailing Address - Phone:662-233-4958
Mailing Address - Fax:901-380-1340
Practice Address - Street 1:2606 CORPORATE AVE E
Practice Address - Street 2:SUITE 201
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38132-1708
Practice Address - Country:US
Practice Address - Phone:901-380-4404
Practice Address - Fax:901-380-1340
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MSR852397163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health