Provider Demographics
NPI:1033352547
Name:HALL, REBECCA L (PA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:HALL
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:4505 COLUMBUS ST STE 250
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-5011
Mailing Address - Country:US
Mailing Address - Phone:757-668-7546
Mailing Address - Fax:757-668-8788
Practice Address - Street 1:885 KEMPSVILLE RD
Practice Address - Street 2:SUITE 224
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3800
Practice Address - Country:US
Practice Address - Phone:757-455-6714
Practice Address - Fax:757-461-3720
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2024-09-25
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Provider Licenses
StateLicense IDTaxonomies
VA0110002359363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
019313B28Medicare PIN